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General NPI Number Information
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NPI Number | 1003800798
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF MIDWEST CITY, LLC
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 8121 NATIONAL AVE SUITE 108
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City | MIDWEST CITY
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State | OK
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Zip | 73110-7530
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Country | US
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Telephone | 405-732-7905
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Fax | 405-741-4622
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Provider Business Mailing Address
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Address Line | 8121 NATIONAL AVE SUITE 108
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City | MIDWEST CITY
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State | OK
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Zip | 73110-7530
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Country | US
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Telephone | 405-732-7905
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Fax | 405-741-4622
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHERRY MILLS
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Credential | RN,BSN
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Telephone | 405-732-7905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0025
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License Number State | OK
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