Provider Demographics
NPI:1790936623
Name:SAINTS MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:SAINTS MEDICAL GROUP, LLC
Other - Org Name:SAINTS FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLIENT ACCOUNT REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-231-3817
Mailing Address - Street 1:PO BOX 248834
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8834
Mailing Address - Country:US
Mailing Address - Phone:405-231-3857
Mailing Address - Fax:405-942-7743
Practice Address - Street 1:10001 S WESTERN AVE
Practice Address - Street 2:STE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2997
Practice Address - Country:US
Practice Address - Phone:405-691-4520
Practice Address - Fax:405-692-3349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty