Organization
MEDICAL CENTER A.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI L. TRUSSELL (ADMINISTRATOR)
(405) 280-5826
Entity
Organization
Contact information
Practice address
701 NE 10TH ST, SUITE 124, OKLAHOMA CITY, OK 73104-5403
(405) 280-5510
(405) 280-5248
Mailing address
701 NE 10TH ST, SUITE 124, OKLAHOMA CITY, OK 73104-5403
(405) 280-5510
(405) 280-5248
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0038
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200023310A
—
OK
Enumeration date
12/05/2006
Last updated
11/05/2009
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