Healthcare Provider Details

I. General information

NPI: 1639478753
Provider Name (Legal Business Name): SSM HEALTHCARE OF OKLAHOMA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NW 9TH ST SUITE 4106
OKLAHOMA CITY OK
73102-1068
US

IV. Provider business mailing address

1000 N LEE AVE
OKLAHOMA CITY OK
73102-1036
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-8499
  • Fax: 405-272-7937
Mailing address:
  • Phone: 405-272-7000
  • Fax: 495-272-6477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRIS D HOWARD
Title or Position: PRESIDENT
Credential:
Phone: 405-272-7279