Organization
SAINTS MEDICAL GROUP, LLC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Medical Group Moore Primary Care
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
1400 SE 4TH ST, MOORE, OK 73160-7329
(405) 799-7400
(405) 799-7405
Mailing address
1400 SE 4TH ST, MOORE, OK 73160-7329
(405) 799-7400
(405) 799-7405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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