Osumc Professional Services LLC
Family Medicine, Sports Medicine in Sand Springs, OK. Organization (NPI-2).
NPI number1154845501
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1154845501
- Entity type
- Organization (NPI-2)
- Legal business name
- Osumc Professional Services LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 27, 2017
- Last updated
- Jul 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QS0010X | Family Medicine, Sports Medicine | 5451 | OK | Yes |
Other names
- Osu Medical Group Sand Springs Primary Care (Doing Business As)
Practice location
514 Plaza CtSand Springs, OK 74063-7915
Phone 918-215-5100 · Fax 918-215-5105
Mailing address
514 Plaza CtSand Springs, OK 74063-7915
Phone 918-215-5100 · Fax 918-215-5105
Authorized official
Samantha Overfield
Credentialing Administrator
9185615714
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