Organization
JEFFREY T SHAVER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY L. SHAVER RN. (ADMINISTRATOR)
(405) 834-0532
Entity
Organization
Contact information
Practice address
3840 S BOULEVARD, SUITE 101, EDMOND, OK 73013-5478
(405) 471-5252
(405) 726-8530
Mailing address
3431 S BOULEVARD ST, SUITE 106, EDMOND, OK 73013-5475
(405) 562-2036
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20009910A
—
OK
01
—
DF7884
MEDICARE RAILROAD
OK
Enumeration date
11/17/2006
Last updated
11/28/2012
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