Healthcare Provider Details
I. General information
NPI: 1770794893
Provider Name (Legal Business Name): SEMINOLE HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2401 W WRANGLER BLVD
SEMINOLE OK
74868-1917
US
IV. Provider business mailing address
3555 NW 58TH ST SUITE 900
OKLAHOMA CITY OK
73112-4707
US
V. Phone/Fax
- Phone: 405-303-4000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
SCHUSTER
Title or Position: PRESIDENT
Credential:
Phone: 405-917-0300