MEDICARE: ROCK SPRINGS MEDICAL CENTER, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1730170226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK SPRINGS MEDICAL CENTER, P.C.

Provider Business Mailing Address
First Line	:	8803 S 101ST EAST AVE
Second Line	:	SUITE 320
City	:	TULSA
State	:	OK
Zip	:	74133-5726
Country	:	US
Telephone Number	:	918-250-7625
Fax Number	:	918-250-7635

Provider Business Practice Location Address
First Line	:	8803 S 101ST EAST AVE
Second Line	:	SUITE 320
City	:	TULSA
State	:	OK
Zip	:	74133-5726
Country	:	US
Telephone Number	:	918-250-7625
Fax Number	:	918-250-7635

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	CYNTHIA JOAN MCCOY
Credential	:	M.D.
Telephone Number	:	918-250-7625

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	08/22/2020

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