Organization
ADVANCED FAMILY THERAPEUTIC
Active
Other names
Bishopcreek Medical and Counseling Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY E SHADID MD (CO OWNER)
(405) 579-5858
Entity
Organization
Contact information
Practice address
3280 MARSHALL AVE, NORMAN, OK 73072
(405) 579-5858
(405) 292-1787
Mailing address
3280 MARSHALL AVE, NORMAN, OK 73072-8028
(405) 579-5858
(405) 292-1787
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200019720A
—
OK
Enumeration date
10/10/2005
Last updated
09/08/2008
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