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Organization

SAINT MEDICAL GROUP, LLC

Active
Other names
Family Healthcare Clinic Shawnee
Organization subpart
No

Provider details

NPI number
Authorized official
SHASTA R MANUEL (VICE PRESIDENT - FINANCE)
(405) 272-7282
Entity
Organization

Contact information

Practice address
3204 MEDICAL PARK DR, SHAWNEE, OK 74804-5014
(405) 878-6800
(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
207Q00000X
Family Medicine Physician
Primary
208600000X
Surgery Physician

Other

Enumeration date
05/10/2016
Last updated
09/02/2025
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