Organization
SAINT MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Bone & Joint Injury Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC.
Authorized official
CRYSTAL L PENA (INSURANCE CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization
Contact information
Practice address
13401 N WESTERN AVE STE 100, OKLAHOMA CITY, OK 73114-1409
(405) 252-3441
(405) 252-3434
Mailing address
13401 N WESTERN AVE STE 100, OKLAHOMA CITY, OK 73114-1409
(405) 252-3441
(405) 252-3434
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2080S0010X
Pediatric Sports Medicine Physician
—
—
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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