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Organization

SAINTS MEDICAL GROUP, LLC

Active
Organization subpart
No

Provider details

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

Contact information

Practice address
3315 KETHLEY RD, SHAWNEE, OK 74804-9638
(405) 273-5801
(405) 878-3794
Mailing address
PO BOX 258884, OKLAHOMA CITY, OK 73125-8884
(405) 273-5801
(405) 878-3794

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
207N00000X
Dermatology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207U00000X
Nuclear Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
207W00000X
Ophthalmology Physician
207X00000X
Orthopaedic Surgery Physician
208000000X
Pediatrics Physician
208100000X
Physical Medicine & Rehabilitation Physician
2085R0202X
Diagnostic Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician
208600000X
Surgery Physician
208800000X
Urology Physician

Other

Enumeration date
05/20/2006
Last updated
03/27/2024
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