Individual
JEFFREY ROBERT SHUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 W BRIDGE AVE, BLACKWELL, OK 74631-2800
(580) 363-3501
(580) 363-3477
Mailing address
115 W BRIDGE AVE, BLACKWELL, OK 74631-2800
(580) 363-3501
(580) 363-3477
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
18498
OK
207Q00000X
Family Medicine Physician
Primary
18498
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100230950A
—
OK
Enumeration date
06/22/2005
Last updated
04/03/2026
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