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General NPI Number Information
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NPI Number | 1881797108
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Entity Type | Individual
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Provider Name | STEVE R. SHOOK O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/14/2013
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Provider Practice Location Address
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Address Line | 1014 W 29TH ST S
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City | WICHITA
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State | KS
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Zip | 67217-3114
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Country | US
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Telephone | 316-613-2033
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Fax | 316-613-2237
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Provider Business Mailing Address
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Address Line | 1014 W 29TH ST S
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City | WICHITA
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State | KS
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Zip | 67217-3114
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Country | US
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Telephone | 316-613-2033
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Fax | 316-613-2237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1076-3
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License Number State | KS
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