Healthcare Provider Details

I. General information

NPI: 1255870820
Provider Name (Legal Business Name): CAITLIN SCHAEDE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2017
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 13TH ST STE A
GROVE OK
74344-2962
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US

V. Phone/Fax

Practice location:
  • Phone: 918-786-9900
  • Fax: 918-786-9904
Mailing address:
  • Phone: 918-786-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6490
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: