Organization
OKLAHOMA SURGICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE A FOSTER (EXECUTIVE DIRECTOR)
(405) 312-3038
Entity
Organization
Contact information
Practice address
401 SW 80TH ST STE 101, OKLAHOMA CITY, OK 73139-8123
(405) 286-9465
(405) 286-9462
Mailing address
PO BOX 6370, EDMOND, OK 73083-6370
(405) 312-3038
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
08/30/2011
Last updated
08/02/2022
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