Provider Demographics
NPI:1245427558
Name:ST. JOHN PHYSICIANS, INC.
Entity Type:Organization
Organization Name:ST. JOHN PHYSICIANS, INC.
Other - Org Name:SJP HAND SURGERY - MICHAEL CLENDENIN, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MERRI
Authorized Official - Middle Name:C
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-748-7863
Mailing Address - Street 1:2000 S WHEELING AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5649
Mailing Address - Country:US
Mailing Address - Phone:918-749-1418
Mailing Address - Fax:918-748-6241
Practice Address - Street 1:2000 S WHEELING AVE
Practice Address - Street 2:SUITE 900
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5649
Practice Address - Country:US
Practice Address - Phone:918-749-1418
Practice Address - Fax:918-748-6241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty