Organization
SHAWNEE MEDICAL CENTER CLINIC, INC
Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Radiation Oncology Shawnee
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC.
Authorized official
CRYSTAL L PENA (CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization
Contact information
Practice address
1102 W MACARTHUR ST, SHAWNEE, OK 74804-1743
(405) 272-7311
(405) 272-6962
Mailing address
1102 W MACARTHUR ST, SHAWNEE, OK 74804-1743
(405) 272-7311
(405) 272-6962
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
2471R0002X
Radiation Therapy Radiologic Technologist
—
—
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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