Healthcare Provider Details

I. General information

NPI: 1730339383
Provider Name (Legal Business Name): SAINTS MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N LEE AVE SUITE 334
OKLAHOMA CITY OK
73103-2600
US

IV. Provider business mailing address

PO BOX 248830
OKLAHOMA CITY OK
73124-8830
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-8326
  • Fax: 405-272-4956
Mailing address:
  • Phone: 405-272-8326
  • Fax: 405-272-4956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

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