Southcrest Medical Group LLC

Organization Active NPI General Practice Physician · Tulsa, OK

NPI 1992736250 · NPPES record last updated Apr 20, 2008

Key facts

NPI
1992736250
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
SOUTHCREST MEDICAL GROUP LLC
Practice address
6528 E 101St St
Ste I
Tulsa, OK 74133-6724
Phone
(918) 294-4803
NPI assigned
Jul 5, 2006
Organization subpart
No

Authorized official

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

National Provider Directory

Locations

6528 E 101st St
Ste I
Tulsa, OK 74133
Phone (918) 294-4803

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

6528 E 101St St
Ste I
Tulsa, OK 74133-6724

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37027-2829

Other providers in Tulsa, OK

All providers in Tulsa, OK · General Practice Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.