# SAINTS MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAINTS MEDICAL GROUP, LLC
- **Other names:** Saints at Shepherd Mall
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366644577
- **Legal business name:** SAINTS MEDICAL GROUP, LLC
- **Authorized official:** SYNOVIA F BAIN (CLIENT ACCOUNT ADMINISTRATOR)
- **Authorized official phone:** (405) 231-3824

## Contact information

- **Practice address:** 2401 SW 23RD ST, SUITE 101, OKLAHOMA CITY, OK 73108
- **Practice address phone:** (405) 948-6300
- **Practice address fax:** (405) 948-6301
- **Mailing address:** PO BOX 268960, OKLAHOMA CITY, OK 73126-8960
- **Mailing address phone:** (405) 231-3857
- **Mailing address fax:** (405) 942-7743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 08/08/2007