Organization
STILLWATER MEDICAL CENTER AUTHORITY
Active
Other names
Stillwater Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G MOELLER (PRESIDENT/CEO)
(405) 742-5230
Entity
Organization
Contact information
Practice address
5200 W 6TH AVE, STILLWATER, OK 74074-6701
(405) 780-7000
Mailing address
1323 W 6TH AVE, P.O. BOX 2408, STILLWATER, OK 74074-4306
(405) 742-5230
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0058
OK
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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