Shawnee Medical Center Clinic, INC

NPI #1205301231 in Shawnee, Oklahoma

Provider Information

NPI Number: 1205301231
Entity Type: Organization
Organization Name: Shawnee Medical Center Clinic, INC
Primary Specialty: Social Worker
Enumeration Date: Oct 5, 2018
Last Updated: Oct 5, 2018

Practice Location

Address: 3315 KETHLEY RD
City: Shawnee
State: Oklahoma
ZIP Code: 74804-9638
Phone: (405) 273-5801

Authorized Official

Name: CRYSTAL L PENA
Title: INSURANCE CREDENTIALING SPECIALIST
Phone: (405) 272-7452

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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