NPI 1033302906

Spine Care of Oklahoma, LLC

Organisation Preferred Provider Organization Edmond, OK

Practice location

Address: 508 W 15th St, Edmond, OK 73013-3615
Phone: (405) 840-5100
Fax: (405) 840-5102

Authorised official

Name: Edward a Shadid
Title: Business Owner
Phone: (405) 840-5100

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 22294 (OK)

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Registry record

NPI: 1033302906
Entity type: Organization
NPI issued: 23 Aug 2007
Record last updated: 15 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.