Provider Demographics
NPI:1912187683
Name:SOONER MEDICAL MANAGEMENT
Entity type:Organization
Organization Name:SOONER MEDICAL MANAGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DANKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-741-0047
Mailing Address - Street 1:1800 S DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6224
Mailing Address - Country:US
Mailing Address - Phone:405-733-4985
Mailing Address - Fax:405-737-4041
Practice Address - Street 1:1800 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6224
Practice Address - Country:US
Practice Address - Phone:405-733-4985
Practice Address - Fax:405-737-4041
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST CITY HMA PHYSICIAN MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty