Organization
SSM HEALTHCARE OF OKLAHOMA, INC
Active
Parent organization
SSM HEALTHCARE OF OKLAHOMA, INC
Other names
St Anthony Vascular Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTHCARE OF OKLAHOMA, INC
Authorized official
CRYSTAL L PENA (CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization
Contact information
Practice address
608 NW 9TH ST, SUITE 5204, OKLAHOMA CITY, OK 73102-1068
(405) 232-2178
(405) 232-6617
Mailing address
PO BOX 269064, OKLAHOMA CITY, OK 73126-9064
(405) 272-7452
(405) 272-7937
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
04/06/2011
Last updated
07/07/2011
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