Organization
MERCY HEALTH NETWORK OF THE SOUTHERN REGION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALINDA S BURDICK (PRESIDENT AND CEO)
(580) 220-6611
Entity
Organization
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6611
(580) 220-6185
Mailing address
4401 W MEMORIAL RD, SUITE #141, OKLAHOMA CITY, OK 73134-1785
(405) 936-5811
(405) 936-5810
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200073380A
—
OK
05
—
200073380C
—
OK
Enumeration date
07/17/2006
Last updated
08/20/2009
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