Organization
OUTPATIENT SURGICAL CENTER OF PONCA CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFFI MARIE COWAN (ADMINISTRATOR)
(580) 762-0695
Entity
Organization
Contact information
Practice address
400 FAIRVIEW AVE, STE 50, PONCA CITY, OK 74601-1920
(580) 762-0695
(580) 765-9406
Mailing address
400 FAIRVIEW AVE, STE 50, PONCA CITY, OK 74601-1920
(580) 762-0695
(580) 765-9406
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/18/2007
Last updated
11/01/2010
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