# SOUTHCREST LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386947604
- **Authorized official:** DEBBIE BREWER (DIRECTOR)
- **Authorized official phone:** (877) 892-9813

## Contact information

- **Practice address:** 8803 S 101ST EAST AVE, SUITE 160, TULSA, OK 74133-5726
- **Practice address phone:** (918) 294-2100
- **Practice address fax:** (918) 294-2110
- **Mailing address:** 7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0063 | OK | Yes |

## Other

- **Enumeration date:** 12/08/2010
- **Last updated:** 03/01/2011