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General NPI Number Information
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NPI Number | 1942469887
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Entity Type | Organization
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Legal Business Name | SSM HEALTH CARE OF OKLAHOMA INC
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 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 | 405-272-5943
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Fax | 405-272-5946
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Provider Business Mailing Address
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Address Line | PO BOX 268802
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-8802
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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