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Organization
SOUTHCREST LLC
Active
Organization
SOUTHCREST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
8803 S 101ST EAST AVE, SUITE 160, TULSA, OK 74133-5726
(918) 294-2100
(918) 294-2110
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0063
OK
Other
Enumeration date
12/08/2010
Last updated
03/01/2011
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