Healthcare Provider Details
I. General information
NPI: 1427097435
Provider Name (Legal Business Name): MERCY HEALTH NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2006
Last Update Date: 12/17/2009
Certification Date:
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
- Phone: 405-936-5800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
E.
NEWMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 405-752-3724