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MERCY HEALTH NETWORK OF THE SOUTHERN REGION INC NPI 1457378184


NPI Information

NPI: 1457378184
Provider Name: MERCY HEALTH NETWORK OF THE SOUTHERN REGION INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1011 14TH AVE NW
ARDMORE, OK
ZIP 73401
Phone: (580) 220-6611
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MERCY HEALTH NETWORK OF THE SOUTHERN REGION INC is a family medicine in Ardmore, OK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MERCY HEALTH NETWORK OF THE SOUTHERN REGION INC NPI is 1457378184. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1011 14TH AVE NW
ARDMORE, OK
ZIP 73401-828
Phone: (580) 220-6611
Fax: (580) 220-6185

The provider's authorized official is Malinda S Burdick .
The authorized official title is President And Ceo and has the following contact phone number (580) 220-6611.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 8/20/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207V00000XObstetrics & GynecologyNo
3363A00000XPhysician AssistantNo
4208M00000XHospitalistNo
5208000000XPediatricsNo
6363L00000XNurse PractitionerNo
7207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200073380AMEDICAIDOKLAHOMA
2200073380CMEDICAIDOKLAHOMA
3600522047MEDICARE PINOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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