Organization
MERCY MEMORIAL EMERGENCY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL DEAN ORCUTT M.D. (PRESIDENT)
(405) 751-4664
Entity
Organization
Contact information
Practice address
1011 14TH AVE NW, ER DEPT., ARDMORE, OK 73401-1828
(580) 220-6415
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04489005
—
MS
01
—
CK6850
RR MEDICARE
OK
Enumeration date
04/04/2006
Last updated
08/22/2020
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