Organization
SSM HEALTHCARE OF OK, INC
Active
Parent organization
SSM HEALTHCARE OF OK, INC
Other names
St Anthony Physicians - Midtown Renal Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTHCARE OF OK, INC
Authorized official
CRYSTAL L PENA (INSURANCE CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization
Contact information
Practice address
810 NW 10TH ST, SUITE A, OKLAHOMA CITY, OK 73106-7215
(405) 272-8367
(405) 272-8373
Mailing address
PO BOX 269064, OKLAHOMA CITY, OK 73126-9064
(405) 272-7452
(405) 272-7937
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
22892
OK
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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