Provider Demographics
NPI:1073954608
Name:SAINTS MEDICAL GROUP LLC
Entity type:Organization
Organization Name:SAINTS MEDICAL GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-272-7452
Mailing Address - Street 1:3700 W ROBINSON ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3659
Mailing Address - Country:US
Mailing Address - Phone:405-772-8657
Mailing Address - Fax:
Practice Address - Street 1:3700 W ROBINSON ST
Practice Address - Street 2:SUITE 108
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3659
Practice Address - Country:US
Practice Address - Phone:405-772-8657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SSM HEALTHCARE OF OK, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty