Individual
DAVID JAMES SHEPHERD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
721 W BROADWAY AVE STE D, ENID, OK 73701-3800
(580) 237-0322
(580) 233-0402
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(580) 237-0322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12880
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123330A
—
OK
01
—
730776935005
BLUE CROSS ID
—
01
—
P00066745
RAILROAD MEDICARE PTAN
—
Enumeration date
06/27/2005
Last updated
03/07/2023
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