Organization
DR SCOTT L SHIELDS PC
Active
Other names
Total Foot & Ankle
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT LAMAR SHIELDS DPM (PODIATRIST)
(580) 237-3338
Entity
Organization
Contact information
Practice address
524 N VAN BUREN, ENID, OK 73703-4455
(580) 237-3338
(580) 237-3399
Mailing address
524 N VAN BUREN, ENID, OK 73703-4455
(580) 237-3338
(580) 237-3399
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
189
OK
332B00000X
Durable Medical Equipment & Medical Supplies
189
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100779730A
—
OK
01
—
10885619
CAQH
OK
01
—
1194848606
GROUP NPI
OK
01
—
1437133436
PERSONAL NPI NUMBER
OK
01
—
1754470500
WORKERS COMP.
OK
01
—
175470500
U.S. DEPT. OF LABOR
OK
01
—
200129000A
MEDICAID DME
OK
05
—
242801356
—
OK
01
—
243726302
MEDICARE GRP MEMBER PTAN
OK
01
—
248801356001
BLUE CROSS BLUE SHIELD
OK
01
—
4800337242
RAILROAD MEDICARE
OK
01
—
OK 189
STATE LICENSURE
OK
Enumeration date
04/09/2007
Last updated
03/07/2023
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