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NPI Code Detail

MEDICARE: PHILIP SHERWOOD SHURLEY PA-C

MEDICARE: PHILIP SHERWOOD SHURLEY PA-C
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
1363A00000XPhysician Assistant434OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942260013
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP SHERWOOD SHURLEY PA-C
Provider Business Mailing Address
First Line : PO BOX 268981
Second Line : MCBRIDE CLINIC, INC.
City : OKLAHOMA CITY
State : OK
Zip : 73126-8981
Country : US
Telephone Number : 405-230-9000
Fax Number : 405-230-9175
Provider Business Practice Location Address
First Line : 1110 N LEE AVE
Second Line : MCBRIDE CLINIC, INC.
City : OKLAHOMA CITY
State : OK
Zip : 73103-2612
Country : US
Telephone Number : 405-230-9000
Fax Number : 405-230-9421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 01/26/2015

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Directions to “ PHILIP SHERWOOD SHURLEY PA-C” Practice Location

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