MEDICARE: STEPHEN SHEFFIELD

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	225100000X	Physical Therapist	5478	OK

General Provider Information

NPI Number	:	1659864072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN SHEFFIELD

Provider Business Mailing Address
First Line	:	3901 NW 56TH PL
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12401 TRAIL OAKS DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-1701
Country	:	US
Telephone Number	:	405-755-5775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	06/11/2018

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Directions to “ STEPHEN SHEFFIELD ” Practice Location

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