# SAINT MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Healthcare Clinic Shawnee
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508212572
- **Authorized official:** SHASTA R MANUEL (VICE PRESIDENT - FINANCE)
- **Authorized official phone:** (405) 272-7282

## Contact information

- **Practice address:** 3204 MEDICAL PARK DR, SHAWNEE, OK 74804-5014
- **Practice address phone:** (405) 878-6800
- **Practice address fax:** (405) 878-3794
- **Mailing address:** PO BOX 958210, SAINT LOUIS, MO 63195-8210
- **Mailing address phone:** (405) 231-3857
- **Mailing address fax:** (405) 272-7977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 05/10/2016
- **Last updated:** 09/02/2025