| NPI | 1194403055 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP ARDMORE |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Provider Enrollment 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |