Organization · Type 2 NPI

Shawnee Medical Center Clinic, Inc

Cardiovascular Disease Physician · Ada, OK

NPI number 1841832755 Active

Practice location

3012 Arlington St
Ada, OK 74820-3073

Fax (580) 272-0772

Specialties and licenses

Taxonomy	Code	License
Pain Medicine (Anesthesiology) Physician	207LP2900X	None listed
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Cardiovascular Disease Physician Primary	207RC0000X	None listed
Gastroenterology Physician	207RG0100X	None listed
Pulmonary Disease Physician	207RP1001X	None listed
Rheumatology Physician	207RR0500X	None listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

6 other providers at this address

Other cardiovascular disease physician providers in Ada

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NPI record

NPI: 1841832755
Entity type: Organization (Type 2)
Issued: Oct 11, 2019
Last updated: Oct 11, 2019
Status: Active
Subpart: Yes of SSM Health Care of Oklahoma, Inc

Other names

SSM Health Specialty Clinic Ada · doing business as

Authorized official

Crystal L Pena
Provider Enrollment/ins Credential
(405) 272-7452

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1841832755

Shawnee Medical Center Clinic, Inc's National Provider Identifier is 1841832755, issued on Oct 11, 2019. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Ada, OK. The record was last updated on Oct 11, 2019.