# MERCY HEALTH SERVICES - SOUTHERN OKLAHOMA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MERCY OCCUPATIONAL MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114982527
- **Authorized official:** BENJAMIN BAKER FORE DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (580) 226-7246

## Contact information

- **Practice address:** 921 14TH AVE NW, ARDMORE, OK 73401-1837
- **Practice address phone:** (580) 223-5311
- **Practice address fax:** (580) 223-8227
- **Mailing address:** 921 14TH AVE NW, ARDMORE, OK 73401-1837
- **Mailing address phone:** (580) 223-5311
- **Mailing address fax:** (580) 223-8227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 05/07/2008