Organization
SPINE CARE OF OKLAHOMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD A SHADID M.D. (BUSINESS OWNER)
(405) 840-5100
Entity
Organization
Contact information
Practice address
508 W 15TH ST, EDMOND, OK 73013-3615
(405) 840-5100
(405) 840-5102
Mailing address
508 W 15TH ST, EDMOND, OK 73013-3615
(405) 615-0290
(405) 840-5102
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
22294
OK
Other
Enumeration date
08/23/2007
Last updated
08/15/2022
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