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Organization

SAINTS MEDICAL GROUP, LLC

Active
Parent organization
SSM HEALTHCARE OF OK, INC
Other names
Saints Dermatology Center of Excellence
Organization subpart
Yes

Provider details

NPI number
Legal business name
SSM HEALTHCARE OF OK, INC
Authorized official
CRYSTAL L PENA (INSURANCE CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization

Contact information

Practice address
9720 BROADWAY EXTENSION, OKLAHOMA CITY, OK 73114
(405) 280-7546
(405) 737-5901
Mailing address
9720 BROADWAY EXTENSION, OKLAHOMA CITY, OK 73114
(405) 280-7546
(405) 737-5901

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
22879
OK

Other

Enumeration date
01/14/2013
Last updated
01/14/2013
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