Organization
SAINTS MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Medical Group North ENT
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
13401 N WESTERN AVE STE 404, OKLAHOMA CITY, OK 73114-1412
(405) 608-4440
(405) 607-3546
Mailing address
13401 N WESTERN AVE STE 404, OKLAHOMA CITY, OK 73114-1412
(405) 608-4440
(405) 607-3546
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0901X
Otology & Neurotology Physician
—
—
231H00000X
Audiologist
—
—
Other
Enumeration date
10/13/2020
Last updated
02/08/2021
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