# SHEA FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578894747
- **Authorized official:** DR. ELENA S SHEA M.D. (OWNER)
- **Authorized official phone:** (580) 475-0175

## Contact information

- **Practice address:** 5112 W GORE BLVD STE 1, LAWTON, OK 73505-5909
- **Practice address phone:** (580) 699-3900
- **Practice address fax:** (580) 699-3901
- **Mailing address:** 5112 W GORE BLVD STE 1, LAWTON, OK 73505-5909
- **Mailing address phone:** (580) 699-3900
- **Mailing address fax:** (580) 699-3901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 24988 | OK | Yes |

## Other

- **Enumeration date:** 01/27/2010
- **Last updated:** 08/11/2010