Healthcare Provider Details

I. General information

NPI: 1356418321
Provider Name (Legal Business Name): MERCY HEALTH NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E MEMORIAL RD
OKLAHOMA CITY OK
73131-1253
US

IV. Provider business mailing address

4300 W MEMORIAL RD ATTN: JAMES E. NEWMAN
OKLAHOMA CITY OK
73120-8304
US

V. Phone/Fax

Practice location:
  • Phone: 405-341-7009
  • Fax: 405-330-1811
Mailing address:
  • Phone: 405-752-3724
  • Fax: 405-752-3811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES E. NEWMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 405-752-3724