Providence Surgical Group at Bailey Pllc

NPI #1376692095 in Owasso, Oklahoma

Provider Information

NPI Number: 1376692095
Entity Type: Organization
Organization Name: Providence Surgical Group at Bailey Pllc
Primary Specialty: Surgery
Enumeration Date: Jan 10, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 10512 N 110TH EAST AVE
Address 2: SUITE 200
City: Owasso
State: Oklahoma
ZIP Code: 74055
Phone: (918) 344-6266

Authorized Official

Name: DR. MICHAEL D MANN, M.D.
Title: OWNER
Phone: (918) 298-2138

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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