Organization
SHAWNEE HEART CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHIR K. GUPTA M.D (OWNER)
(405) 273-0406
Entity
Organization
Contact information
Practice address
3208 MEDICAL PARK DRIVE, SHAWNEE, OK 74804
(405) 273-0406
(405) 273-1799
Mailing address
3208 MEDICAL PARK DRIVE, SHAWNEE, OK 74804
(405) 273-0406
(405) 273-1799
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15887
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100257730A
—
OK
Enumeration date
03/05/2007
Last updated
12/15/2010
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