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NPI Code Detail

MEDICARE: SAINTS MEDICAL GROUP, LLC

MEDICARE: SAINTS MEDICAL GROUP, LLC
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
1207RI0011XInterventional Cardiology Physician20073OK

General Provider Information

NPI Number : 1760716518
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINTS MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : PO BOX 248863
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73124-8863
Country : US
Telephone Number : 580-272-0715
Fax Number : 580-272-0771
Provider Business Practice Location Address
First Line : 3012 ARLINGTON ST
Second Line :
City : ADA
State : OK
Zip : 74820-3073
Country : US
Telephone Number : 580-272-0715
Fax Number : 580-272-0771
Authorized Official
Title or Position : CLIENT ACCOUNT REPRESENTATIVE
Name : KATY BAIN
Credential :
Telephone Number : 405-231-3817
Provider Enumeration Date : 09/28/2009
Last Update Date : 09/28/2009

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Directions to “SAINTS MEDICAL GROUP, LLC ” Practice Location

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