Providence Physician Group Inc
Organization Active NPI Certified Registered Nurse Anesthetist · Muskogee, OK
NPI 1861436636 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1861436636
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- Legal business name
- PROVIDENCE PHYSICIAN GROUP INC
- Practice address
- 300 Rockefeller Dr
Muskogee, OK 74401-5075 - Phone
- (918) 684-2557
- Fax
- (405) 948-6507
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Jim Blair
- Title
- Ceo
- Phone
- (918) 684-2557
Practitioners 23
-
Greg Bachman, MD
-
Paul Powen Cheng, M.D.
-
Sudhir R Daftary, MD
-
Timothy J Frink, D.O.
-
Terry Michael Gile, D.O.
-
Brent Henderson, DO
-
Angela D Huffman, M.D.
-
Regina M Mellen, CRNA
-
James R Patterson, CRNA
-
Ray Shofner, CRNA
-
Bryan S Simms, DO
-
Brad A Starkey, M.D.
-
Brian Neal Stephens, CRNA
-
Nelson Lee Strother, CRNA
-
Charles Floyd Beck, D.O.
-
Michelle Love-Baker, CRNA
-
Danny Eugene McCarty, C.R.N.A.
-
James Mordecai, CRNA
-
Glenn Syperda, DO
National Provider Directory
Locations
Dept 2066
Tulsa, OK 74182
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | |||
| Certified Registered Nurse Anesthetist |
367500000X | Yes |
Addresses
Primary practice location
300 Rockefeller Dr
Muskogee, OK 74401-5075
Mailing address
PO Box 1664
Muskogee, OK 74402-1664
Phone (405) 947-8585
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DA6664 | Other | OK | RAILROAD MEDICARE |
| 3159009 | Other | OK | AETNA |
Other providers in Muskogee, OK
- Premier Vision Center, PLLC
- Dianne Linette Presley
- Mercedes Prewitt
- Procare Healing Centers, LLC
- Prominent Toxicology Screenings LLC
- Christen Eve Pruet
- Preston Lowell Pruett
- Amber Nicole Pruitt
- Angela Pruitt
- Casey Puckett
All providers in Muskogee, OK · Certified Registered Nurse Anesthetist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.