Organization
SAINT MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Medical Group at Chesapeake
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
2749 PROGRESSIVE DR, EDMOND, OK 73034-7649
(405) 772-4130
(405) 772-4135
Mailing address
2749 PROGRESSIVE DR, EDMOND, OK 73034-7649
(405) 772-4130
(405) 772-4135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
08/11/2020
Last updated
05/07/2021
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