MEDICARE: SAINT MEDICAL GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396116745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	PO BOX 958210
Second Line	:
City	:	ST LOUIS
State	:	OK
Zip	:	63195-8210
Country	:	US
Telephone Number	:	405-231-3857
Fax Number	:	405-272-7977

Provider Business Practice Location Address
First Line	:	114 N HIGHWAY 18
Second Line	:
City	:	CHANDLER
State	:	OK
Zip	:	74834-1200
Country	:	US
Telephone Number	:	405-258-2500
Fax Number	:	405-258-3053

Authorized Official
Title or Position	:	VICE PRESIDENT - FINANCE
Name	:	SHASTA R MANUEL
Credential	:
Telephone Number	:	405-272-7282

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	09/02/2025

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Directions to “SAINT MEDICAL GROUP, LLC ” Practice Location

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