Organization
OWASSO MEDICAL FACILITY LLC
Active
Other names
St John Owasso ER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID L PHILLIPS (CEO)
(918) 744-2113
Entity
Organization
Contact information
Practice address
12451 E 100TH ST N, OWASSO, OK 74055-4600
(918) 274-5000
Mailing address
12451 E 100TH ST N, OWASSO, OK 74055-4600
(918) 274-5000
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
2374
OK
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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