Healthcare Provider Details

I. General information

NPI: 1205048337
Provider Name (Legal Business Name): SAINTS MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N. LEE AVE ROOM 1921
OKLAHOMA CITY OK
73101
US

IV. Provider business mailing address

PO BOX 269007
OKLAHOMA CITY OK
73126
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-6053
  • Fax: 405-272-6928
Mailing address:
  • Phone: 405-231-3857
  • Fax: 405-942-7743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: SYNOVIA F BAIN
Title or Position: CLIENT ACCOUT ADMINISTRATOR
Credential:
Phone: 405-231-3824