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Organization
OSUMC PROFESSIONAL SERVICES LLC
Active
Organization
OSUMC PROFESSIONAL SERVICES LLC
Active
Parent organization
OSUMC PROFESSIONAL SERVICES LLC
Other names
OSU Medical Group Sand Springs Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
OSUMC PROFESSIONAL SERVICES LLC
Authorized official
SAMANTHA OVERFIELD (CREDENTIALING ADMINISTRATOR)
(918) 561-5714
Entity
Organization
Contact information
Practice address
514 PLAZA CT, SAND SPRINGS, OK 74063-7915
(918) 215-5100
(918) 215-5105
Mailing address
514 PLAZA CT, SAND SPRINGS, OK 74063-7915
(918) 215-5100
(918) 215-5105
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
5451
OK
Other
Enumeration date
07/27/2017
Last updated
07/21/2022
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