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Organization
SHAWNEE MEDICAL CENTER CLINIC, INC
Active
Organization
SHAWNEE MEDICAL CENTER CLINIC, INC
Active
Other names
St Anthony Physicians-Stroud Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL L PENA (INSURANCE CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization
Contact information
Practice address
2308 W HIGHWAY 66, SUITE B, STROUD, OK 74079-6729
(918) 968-4469
(918) 968-1618
Mailing address
PO BOX 849, SHAWNEE, OK 74802-0849
(918) 968-4469
(918) 968-1618
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/12/2011
Last updated
12/21/2011
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