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Organization

ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.

Active
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Organization

ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.

Active
Other names
Shawnee Clinic, Absentee Shawnee Tribal Health System - Shawnee Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MARTY LOFGREN MD, CPE (EXECUTIVE/ MEDICAL DIRECTOR)
(405) 447-0300
Entity
Organization

Contact information

Practice address
2029 GORDON COOPER DR, SHAWNEE, OK 74801-9005
(405) 878-5850
(405) 701-7631
Mailing address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7631

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100699860J
OK
05
100699860K
OK
05
100699860L
OK
05
100699860M
OK
Enumeration date
05/18/2006
Last updated
08/24/2026
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