Organization
SAINT MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC
Other names
SSM Health Medical Group Otology
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC
Authorized official
CRYSTAL L PENA (PROVIDER ENROLLMENT COORDINATOR)
(405) 272-7452
Entity
Organization
Contact information
Practice address
3400 NW 56TH ST, OKLAHOMA CITY, OK 73112-4463
(405) 946-5563
(405) 947-6226
Mailing address
3400 NW 56TH ST, OKLAHOMA CITY, OK 73112-4463
(405) 946-5563
(405) 947-6226
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
—
—
231H00000X
Audiologist
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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