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General NPI Number Information
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NPI Number | 1053446120
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Entity Type | Organization
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Legal Business Name | SAINTS MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 1111 N LEE AVE SUITE 334
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City | OKLAHOMA CITY
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State | OK
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Zip | 73103-2600
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Country | US
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Telephone | 405-272-4953
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Fax | 405-272-4956
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Provider Business Mailing Address
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Address Line | PO BOX 268972
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-8972
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Country | US
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Telephone | 405-272-4953
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Fax | 405-272-4956
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Authorized Official
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Title or Position | CLIENT ACCOUNT REPRESENTATIVE
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Name | KATY BAIN
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Credential |
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Telephone | 405-231-3817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 27645
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License Number State | OK
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