Southcrest LLC

Organization Active NPI Ambulatory Surgical Clinic/Center · Tulsa, OK

NPI 1386947604 · NPPES record last updated Mar 1, 2011

Key facts

NPI
1386947604
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
License
0063 (OK)
Legal business name
SOUTHCREST LLC
Practice address
8803 S 101St East Ave
Suite 160
Tulsa, OK 74133-5726
Phone
(918) 294-2100
Fax
(918) 294-2110
NPI assigned
Dec 8, 2010
Organization subpart
No

Authorized official

Name
Debbie Brewer
Title
Director
Phone
(877) 892-9813

National Provider Directory

Locations

8803 S 101st East Ave
Ste 160
Tulsa, OK 74133
Phone (918) 294-2100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0063 OK Yes

Addresses

Primary practice location

8803 S 101St East Ave
Suite 160
Tulsa, OK 74133-5726

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37027-2829

Other identifiers

IdentifierTypeStateIssuer
PENDINGMedicaidOK

Other providers in Tulsa, OK

All providers in Tulsa, OK · Ambulatory Surgical Clinic/Center in Oklahoma

Sources for this page

Verify at the official NPI Registry.