Organization
ARDMORE REGIONAL SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY A GODFREY CASC (ADMINISTRATOR)
(580) 224-0007
Entity
Organization
Contact information
Practice address
2002 12TH AVE NW, SUITE C, ARDMORE, OK 73401-1227
(580) 224-0007
(580) 223-7140
Mailing address
2002 12TH AVE NW, SUITE C, ARDMORE, OK 73401-1227
(580) 224-0007
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0064
OK
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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