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General NPI Number Information
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NPI Number | 1942499496
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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 | 10/22/2007
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 100 W MAIN ST SUITE 200
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-9024
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Country | US
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Telephone | 405-815-5060
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Fax | 405-815-5065
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Provider Business Mailing Address
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Address Line | PO BOX 268966
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-8966
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Country | US
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Telephone | 405-231-3857
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Fax | 405-272-7977
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Authorized Official
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Title or Position | INSURANCE CREDENTIALING SPECIALIST
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Name | CRYSTAL L PENA
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Credential |
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Telephone | 405-272-7452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal 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 | 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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