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Individual

DR. SCOTT LAMAR SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

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
213E00000X
Podiatrist
368
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100779730A
OK
01
1754470500
DEPT. OF LABOR
OK
01
7315168723701A001
TRICARE
Enumeration date
12/02/2005
Last updated
01/31/2008
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