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Organization
SAINT MEDICAL GROUP, LLC
Active
Organization
SAINT MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA INC
Other names
SSM Health Harrah Ambulatory Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTH CARE OF OKLAHOMA INC
Authorized official
CRYSTAL L PENA (PROVIDER ENROLLMENT)
(405) 272-7452
Entity
Organization
Contact information
Practice address
18961 NE 23RD STREET, HARRAH, OK 73045
(405) 772-4650
(405) 772-4653
Mailing address
18961 NE 23RD STREET, HARRAH, OK 73045
(405) 772-4650
(405) 772-4653
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/19/2007
Last updated
03/22/2022
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