| NPI | 1669018057 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP ORTHO MUSTANG |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Credentialing Specialist 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |