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Organization
OUTPATIENT SURGICAL CENTER OF PONCA CITY, LLC
Active
Organization
OUTPATIENT SURGICAL CENTER OF PONCA CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEFFI MOON COWAN (ADMINISTRATOR)
(580) 762-0695
Entity
Organization
Contact information
Practice address
400 FAIRVIEW AVE, SUITE 50, PONCA CITY, OK 74601-1920
(580) 762-0695
(580) 765-9406
Mailing address
400 FAIRVIEW AVE, SUITE 50, PONCA CITY, OK 74601-1920
(580) 762-0695
(580) 765-9406
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0021
OK
Other
Enumeration date
04/25/2006
Last updated
11/01/2010
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