# STILLWATER MEDICAL CENTER AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stillwater Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538491220
- **Authorized official:** JERRY G MOELLER (PRESIDENT/CEO)
- **Authorized official phone:** (405) 742-5230

## Contact information

- **Practice address:** 5200 W 6TH AVE, STILLWATER, OK 74074-6701
- **Practice address phone:** (405) 780-7000
- **Mailing address:** 1323 W 6TH AVE, P.O. BOX 2408, STILLWATER, OK 74074-4306
- **Mailing address phone:** (405) 742-5230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0058 | OK | Yes |

## Other

- **Enumeration date:** 02/04/2010
- **Last updated:** 02/04/2010