# SSM HEALTHCARE OF OKLAHOMA, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SSM HEALTHCARE OF OKLAHOMA, INC
- **Other names:** St Anthony Vascular Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033408497
- **Legal business name:** SSM HEALTHCARE OF OKLAHOMA, INC
- **Authorized official:** CRYSTAL L PENA (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (405) 272-7452

## Contact information

- **Practice address:** 608 NW 9TH ST, SUITE 5204, OKLAHOMA CITY, OK 73102-1068
- **Practice address phone:** (405) 232-2178
- **Practice address fax:** (405) 232-6617
- **Mailing address:** PO BOX 269064, OKLAHOMA CITY, OK 73126-9064
- **Mailing address phone:** (405) 272-7452
- **Mailing address fax:** (405) 272-7937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2011
- **Last updated:** 07/07/2011