Organization
DAVID L SHADID DO INC
Active
Organization
DAVID L SHADID DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID L SHADID DO (PRESIDENT PHYSICIAN)
(918) 747-5565
Entity
Organization
Contact information
Practice address
4612 S HARVARD AVE, STE A, TULSA, OK 74135-2908
(918) 747-5565
(918) 747-5568
Mailing address
4612 S HARVARD AVE, STE A, TULSA, OK 74135-2908
(918) 747-5565
(918) 747-5568
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2930
OK
2084P0804X
Child & Adolescent Psychiatry Physician
2930
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200012860A
—
OK
Enumeration date
10/02/2006
Last updated
12/02/2014
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