Provider Demographics
NPI:1699948646
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:CLIENT ACCOUNT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYNOVIA
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-231-3824
Mailing Address - Street 1:PO BOX 248804
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8804
Mailing Address - Country:US
Mailing Address - Phone:405-231-3857
Mailing Address - Fax:405-942-7743
Practice Address - Street 1:7101 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-5159
Practice Address - Country:US
Practice Address - Phone:405-789-1130
Practice Address - Fax:405-789-1132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINTS MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-10
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty