Saints Medical Group, LLC

NPI #1952994832 in Moore, Oklahoma

Provider Information

NPI Number: 1952994832
Entity Type: Organization
Organization Name: Saints Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SSM HEALTH CARE OF OKLAHOMA, INC.
Primary Specialty: Physician Assistant
Enumeration Date: Feb 11, 2021
Last Updated: Feb 11, 2021

Practice Location

Address: 1400 SE 4TH ST
City: Moore
State: Oklahoma
ZIP Code: 73160-7329
Phone: (405) 799-7400

Authorized Official

Name: CRYSTAL L PENA
Title: PROVIDER ENROLLMENT
Phone: (405) 272-7452

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X
Nurse Practitioner	363L00000X
Physician Assistant	363A00000X	Primary

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