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Organization
SAINT MEDICAL GROUP, LLC
Active
Organization
SAINT MEDICAL GROUP, LLC
Active
Other names
SSM Health Shawnee Ambulatory Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHASTA R MANUEL (VICE PRESIDENT - FINANCE)
(405) 272-7282
Entity
Organization
Contact information
Practice address
4651 N HARRISON, SHAWNEE, OK 74804
(405) 273-5801
(405) 878-3794
Mailing address
PO BOX 958210, SAINT LOUIS, MO 63195-8210
(405) 231-3857
(405) 272-7977
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Enumeration date
11/06/2020
Last updated
09/02/2025
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