Provider Demographics
NPI:1295075976
Name:SPMG SIGNATURE PAMPA MEDICAL GROUP
Entity type:Organization
Organization Name:SPMG SIGNATURE PAMPA MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:STERLING
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-663-5500
Mailing Address - Street 1:ONE MEDICAL PLAZA
Mailing Address - Street 2:ATTN: PAMPA MEDICAL GROUP CLINIC DIRECTOR
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2814
Mailing Address - Country:US
Mailing Address - Phone:806-663-5500
Mailing Address - Fax:
Practice Address - Street 1:ONE MEDICAL PLAZA
Practice Address - Street 2:ATTN: PAMPA MEDICAL GROUP CLINIC DIRECTOR
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2814
Practice Address - Country:US
Practice Address - Phone:806-663-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty