| OSU Medical Group | |
|
112 W 5th Street Okmulgee OK 74447-0000 | |
| (918) 752-1080 | |
| (918) 752-1081 |
| Full Name | OSU Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 112 W 5th Street, Okmulgee, Oklahoma |
| Authorized Official Name and Position | Samantha Kay Overfield (CREDENTIALING ADMINISTRATOR) |
| Authorized Official Contact | 9185615714 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| OSU Medical Group 2401 Southwest Blvd Tulsa OK 74107-2726 Ph: (918) 561-5701 | OSU Medical Group 112 W 5th Street Okmulgee OK 74447-0000 Ph: (918) 752-1080 |
| NPI Number | 1730793696 |
|---|---|
| Provider Enumeration Date | 09/08/2020 |
| Last Update Date | 09/08/2020 |
| Certification Date | 09/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730793696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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