| NPI | 1356803308 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP FAMILY MEDICINE EL RENO |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Insurance Credentialing Specialist 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-04-01 |