Organization
ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY LOFGREN MD, CPE (MEDICAL DIRECTOR)
(405) 447-0300
Entity
Organization
Contact information
Practice address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7914
Mailing address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7914
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100699860A
—
OK
05
—
100699860N
—
OK
05
—
100699860O
—
OK
05
—
100699860P
—
OK
Enumeration date
03/15/2007
Last updated
10/27/2025
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