Healthcare Provider Details

I. General information

NPI: 1710047550
Provider Name (Legal Business Name): MERCY HEALTH NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 N SANTA FE AVE
EDMOND OK
73003-3638
US

IV. Provider business mailing address

4300 W MEMORIAL RD ATTN: JAMES E. NEWMAN
OKLAHOMA CITY OK
73120-8304
US

V. Phone/Fax

Practice location:
  • Phone: 405-285-0660
  • Fax: 405-285-0659
Mailing address:
  • Phone: 405-752-3724
  • Fax: 405-752-3811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES E. NEWMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 405-752-3724