Provider Demographics
NPI:1336327832
Name:SAINTS MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:SAINTS MEDICAL GROUP, LLC
Other - Org Name:SAINTS VASCULAR ASSOCIATES
Other - Org Type:Doing Business As
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 248802
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124
Mailing Address - Country:US
Mailing Address - Phone:405-232-2178
Mailing Address - Fax:405-272-6617
Practice Address - Street 1:608 NW 9TH ST
Practice Address - Street 2:STE 5204
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1068
Practice Address - Country:US
Practice Address - Phone:405-232-2178
Practice Address - Fax:405-232-6617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty