Healthcare Provider Details

I. General information

NPI: 1730744160
Provider Name (Legal Business Name): SHANNON MARIE DELANEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON MCBEATH

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 S ELM PL
BROKEN ARROW OK
74012-5369
US

IV. Provider business mailing address

7711 E 111TH ST STE 112
TULSA OK
74133-2563
US

V. Phone/Fax

Practice location:
  • Phone: 918-928-5437
  • Fax: 888-720-8944
Mailing address:
  • Phone: 918-928-5437
  • Fax: 888-720-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6967
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: