MEDICARE: MOSAIC FOUNDATION SOUTH OKC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1285260679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSAIC FOUNDATION SOUTH OKC

Provider Business Mailing Address
First Line	:	701 NE 36TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73105-7203
Country	:	US
Telephone Number	:	405-445-7492
Fax Number	:	405-445-7492

Provider Business Practice Location Address
First Line	:	1317 SE 44TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73129-6906
Country	:	US
Telephone Number	:	405-631-0611
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SCOTT MAYER
Credential	:	MD
Telephone Number	:	405-445-7492

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	03/17/2020

Similar Medicare Providers

1710224571 — JOHNNY T NG NP
Practice Location Address:

1317 SE 44TH ST
OKLAHOMA CITY, OK
73129-6906

Practice Phone: 405-615-3801
Practice Fax:

1750755583 — TODAY CLINIC PLLC
Practice Location Address:

1317 SE 44TH ST , SUITE I
OKLAHOMA CITY, OK
73129-6906

Practice Phone: 405-631-0611
Practice Fax: 405-631-0811

1083197412 — MADISON NICOLE RICHARDSON RN
Practice Location Address:

2942 NW 30TH ST
OKLAHOMA CITY, OK
73112-6906

Practice Phone: 405-570-6339
Practice Fax:

1528926631 — LAUREN MARIE WALLACE PA-C
Practice Location Address:

5400 E TEXAS ST
BOSSIER CITY, LA
71111-6906

Practice Phone: 318-675-1313
Practice Fax: 888-965-0619

1932215456 — DR. HARLAN JAY WEISS M.D.
Practice Location Address:

5400 E TEXAS ST
BOSSIER CITY, LA
71111-6906

Practice Phone: 318-675-1313
Practice Fax:

1548411929 — DR. JOHN CURTIS MCMILLEN MSW, PH.D.
Practice Location Address:

6906 PERSHING AVE
UNIVERSITY CITY, MO
63130-4330

Practice Phone: 314-495-9919
Practice Fax:

Directions to “MOSAIC FOUNDATION SOUTH OKC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.