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Organization

SAINT MEDICAL GROUP, LLC

Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Medical Group Pauls Valley
Organization subpart
Yes

Provider details

NPI number
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC.
Authorized official
CRYSTAL L PENA (PROVIDER ENROLLMENT)
(405) 272-7452
Entity
Organization

Contact information

Practice address
105 N INDIAN MERIDIAN RD, PAULS VALLEY, OK 73075-9236
(405) 207-9800
(405) 207-9898
Mailing address
105 N INDIAN MERIDIAN RD, PAULS VALLEY, OK 73075-9236
(405) 207-9800
(405) 207-9898

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
03/20/2019
Last updated
03/20/2019
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