Individual
DR. PAUL KEITH SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5525 E 51ST ST STE 530, TULSA, OK 74135-7461
(918) 809-1790
(918) 728-3025
Mailing address
120 N VANCOUVER AVE, TULSA, OK 74127-8443
(918) 809-1790
(918) 728-3025
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
583
OK
106H00000X
Marriage & Family Therapist
54
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170392
VALUE OPTIONS
OK
01
—
73-123-5153-01
BCBS
OK
01
—
73-133-6191
TAX ID#
OK
Enumeration date
08/29/2006
Last updated
04/15/2025
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