Provider Demographics
NPI:1306612171
Name:UNITED INDIAN HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:UNITED INDIAN HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:707-825-4065
Mailing Address - Street 1:1600 WEEOT WAY
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4734
Mailing Address - Country:US
Mailing Address - Phone:707-825-5000
Mailing Address - Fax:707-825-6747
Practice Address - Street 1:1675 NORTHCREST DR
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-8928
Practice Address - Country:US
Practice Address - Phone:707-464-2750
Practice Address - Fax:707-464-2668
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED INDIAN HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty