Organization
SAINT MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Medical Group Urogynocology
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
535 NW 9TH ST STE 210, OKLAHOMA CITY, OK 73102-1072
(405) 772-4480
(405) 772-4484
Mailing address
535 NW 9TH ST STE 210, OKLAHOMA CITY, OK 73102-1072
(405) 772-4480
(405) 772-4484
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
—
—
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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