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General NPI Number Information
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NPI Number | 1699948646
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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 | 04/10/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 7101 NW 23RD ST
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City | BETHANY
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State | OK
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Zip | 73008-5159
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Country | US
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Telephone | 405-789-1130
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Fax | 405-789-1132
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Provider Business Mailing Address
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Address Line | PO BOX 248804
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City | OKLAHOMA CITY
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State | OK
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Zip | 73124-8804
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Country | US
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Telephone | 405-231-3857
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Fax | 405-942-7743
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Authorized Official
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Title or Position | CLIENT ACCOUNT ADMINISTRATOR
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Name | SYNOVIA FAITH BAIN
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Credential |
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Telephone | 405-231-3824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 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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