Healthcare Provider Details

I. General information

NPI: 1386874550
Provider Name (Legal Business Name): MERCY CLINIC OKLAHOMA COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W MEMORIAL RD
OKLAHOMA CITY OK
73120-8304
US

IV. Provider business mailing address

4300 W MEMORIAL RD
OKLAHOMA CITY OK
73120-8304
US

V. Phone/Fax

Practice location:
  • Phone: 405-752-3333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRIS HAHNE
Title or Position: CFO
Credential:
Phone: 405-936-5649