NPI 1861034779

Shawnee Medical Center Clinic, INC.

Organisation Family Medicine Physician Seminole, OK

Practice location

Address: 2403 W Wrangler Blvd STE C, Seminole, OK 74868-1900
Phone: (405) 716-3070
Fax: (405) 716-3069

Authorised official

Name: Crystal L Pena
Title: Provider Enrollment/Ins Credential
Phone: (405) 272-7452

Registered specialties (3)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Oklahoma →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Other Physician Assistant providers in Oklahoma →

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

Other Nurse Practitioner providers in Oklahoma →

Registry record

NPI: 1861034779
Entity type: Organization
NPI issued: 11 Oct 2019
Record last updated: 11 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.