Healthcare Provider Details

I. General information

NPI: 1801856471
Provider Name (Legal Business Name): ST ANTHONY NORTH AMBULATORY SURGICAL CENTER L L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6205 N SANTA FE AVE SUITE 100
OKLAHOMA CITY OK
73118-7535
US

IV. Provider business mailing address

6205 N SANTA FE AVE SUITE 100
OKLAHOMA CITY OK
73118-7535
US

V. Phone/Fax

Practice location:
  • Phone: 405-419-5566
  • Fax: 405-419-5401
Mailing address:
  • Phone: 405-419-5566
  • Fax: 405-419-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0055
License Number StateOK

VIII. Authorized Official

Name: MR. DEBBIE FOSTER
Title or Position: CEO
Credential:
Phone: 405-419-5566