Individual
JEFFREY T SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3840 SOUTH BOULEVARD, SUITE 101, EDMOND, OK 73013-5478
(405) 471-5252
(405) 726-8530
Mailing address
3840 SOUTH BOULEVARD, SUITE 101, EDMOND, OK 73013-5478
(405) 471-5252
(405) 726-8530
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16961
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100124540A
—
OK
01
—
P00392904
MEDICARE RAILROAD
OK
Enumeration date
03/16/2006
Last updated
07/17/2023
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