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NPI Code Detail

MEDICARE: SAINT MEDICAL GROUP, LLC

MEDICARE: SAINT 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
1207Q00000XFamily Medicine Physician
2207RC0200XCritical Care Medicine (Internal Medicine) Physician
3207RP1001XPulmonary Disease Physician

General Provider Information

NPI Number : 1932553203
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINT MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 6205 N SANTA FE AVE
Second Line : SUITE 201
City : OKLAHOMA CITY
State : OK
Zip : 73118-7537
Country : US
Telephone Number : 405-272-8338
Fax Number : 405-272-6030
Provider Business Practice Location Address
First Line : 6205 N SANTA FE AVE
Second Line : SUITE 201
City : OKLAHOMA CITY
State : OK
Zip : 73118-7537
Country : US
Telephone Number : 405-272-8338
Fax Number : 405-272-6030
Authorized Official
Title or Position : INSURANCE CREDENTIALING SPECIALIST
Name : CRYSTAL L PENA
Credential :
Telephone Number : 405-272-7452
Provider Enumeration Date : 04/22/2016
Last Update Date : 03/25/2019

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Directions to “SAINT MEDICAL GROUP, LLC ” Practice Location

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