Southcrest Medical Group LLC

NPI #1992736250 in Tulsa, Oklahoma

Provider Information

NPI Number: 1992736250
Entity Type: Organization
Organization Name: Southcrest Medical Group LLC
Primary Specialty: General Practice
Enumeration Date: Jul 5, 2006
Last Updated: Apr 20, 2008

Practice Location

Address: 6528 E 101ST ST
Address 2: STE I
City: Tulsa
State: Oklahoma
ZIP Code: 74133-6724
Phone: (918) 294-4803

Authorized Official

Name: DEBBIE BREWER
Title: DIRECTOR OF PROVIDER ENROLLMENT
Phone: (877) 892-9813

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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