Healthcare Provider Details

I. General information

NPI: 1336327832
Provider Name (Legal Business Name): SAINTS MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NW 9TH ST STE 5204
OKLAHOMA CITY OK
73102-1068
US

IV. Provider business mailing address

PO BOX 248802
OKLAHOMA CITY OK
73124
US

V. Phone/Fax

Practice location:
  • Phone: 405-232-2178
  • Fax: 405-232-6617
Mailing address:
  • Phone: 405-232-2178
  • Fax: 405-272-6617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

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