Shawnee Medical Center Clinic, INC

NPI #1487922993 in Stroud, Oklahoma

Provider Information

NPI Number: 1487922993
Entity Type: Organization
Organization Name: Shawnee Medical Center Clinic, INC
Primary Specialty: Family Medicine
Enumeration Date: Dec 12, 2011
Last Updated: Dec 21, 2011

Practice Location

Address: 2308 W HIGHWAY 66
Address 2: SUITE B
City: Stroud
State: Oklahoma
ZIP Code: 74079-6729
Phone: (918) 968-4469

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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