Shields, Timothy D

Shields, Timothy D is an sole proprietor health care provider with primary practice located at 2412 N Commerce St , Ardmore OK 73401-1356. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Shields, Timothy D can be contacted via phone (580) 226-5000.

Contact Information

Primary practice address
2412 N Commerce St Ardmore OK 73401-1356
Phone: (580) 226-5000
Fax: (580) 226-5035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R0064541 Oklahoma

Profile Details

NPI number 1851347546
LBN Legal business name Shields, Timothy D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 25th, 2006
Last updated Oct 1st, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851347546 NPPES
Oklahoma MEDICAID 200021240A
Oklahoma Other OK401908

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