ST. MARY'S PHYSICIAN ASSOCIATES, LLC

PONCA CITY, OK
NPI1346613833
Doing Business AsST. MARY'S PODIATRY CLINIC
Entity TypeOrganization
Authorized ContactTODD EVANS
Vice President
610-768-3300
Organization Subpart ?No
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2015-11-05
Last Update Date2019-06-28
Business Address
ST. MARY'S PHYSICIAN ASSOCIATES, LLC
1908 N 14TH STREET SUITE 203
PONCA CITY, OK 74601-2039
Phone number: 580-249-3929
Mailing Address
ST. MARY'S PHYSICIAN ASSOCIATES, LLC
PO BOX 844737 ATT: IPM CREDENTIALING
DALLAS, TX 75284-4737
Phone number: 855-298-6628