Healthcare Provider Details

I. General information

NPI: 1962702290
Provider Name (Legal Business Name): SSM HEALTHCARE OF OKLAHOMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N DEWEY AVE
OKLAHOMA CITY OK
73102-1024
US

IV. Provider business mailing address

1011 N DEWEY AVE
OKLAHOMA CITY OK
73102-1024
US

V. Phone/Fax

Practice location:
  • Phone: 405-228-7100
  • Fax: 405-228-7151
Mailing address:
  • Phone: 405-228-7100
  • Fax: 405-228-7151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SHAWN MARIE MORRISON
Title or Position: DIRECTOR OF ONCOLOGY CLINIC
Credential:
Phone: 405-820-9612