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General NPI Number Information
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NPI Number | 1689070047
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Entity Type | Organization
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Legal Business Name | DR. SCOTT L. SHIELDS, P.C.
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 3330 NW 56TH ST SUITE 600
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4479
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Country | US
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Telephone | 405-947-8041
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Fax | 405-947-8043
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Provider Business Mailing Address
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Address Line | 3330 NW 56TH ST SUITE 600
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4479
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Country | US
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Telephone | 405-947-8041
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Fax | 405-947-8043
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT L SHIELDS
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Credential | DPM
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Telephone | 580-237-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 189
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License Number State | OK
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