Provider Demographics
NPI:1073330056
Name:SUPERIOR MEDICAL
Entity type:Organization
Organization Name:SUPERIOR MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-489-5757
Mailing Address - Street 1:PO BOX 1100
Mailing Address - Street 2:
Mailing Address - City:GORE
Mailing Address - State:OK
Mailing Address - Zip Code:74435-1100
Mailing Address - Country:US
Mailing Address - Phone:918-489-5757
Mailing Address - Fax:918-489-5411
Practice Address - Street 1:700 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GORE
Practice Address - State:OK
Practice Address - Zip Code:74435-2013
Practice Address - Country:US
Practice Address - Phone:918-489-5757
Practice Address - Fax:918-489-5411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty