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General NPI Number Information
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NPI Number | 1003872482
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH SERVICES-SOUTHERN REGION, LLC
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1001 15TH AVE NW
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City | ARDMORE
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State | OK
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Zip | 73401-1810
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Country | US
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Telephone | 580-223-3737
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Fax | 580-226-5679
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Provider Business Mailing Address
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Address Line | 4401 W MEMORIAL RD SUITE #141; ATTN: BECKY
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-1785
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Country | US
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Telephone | 405-936-5811
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Fax | 405-936-5810
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Authorized Official
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Title or Position | VP/CFO
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Name | MARK A. NAFZIGER
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Credential |
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Telephone | 405-752-3724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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