SCOTT SHADFAR (NPI# 1710148283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710148283 |
| Entity Type | Individual |
| Full Name | SCOTT SHADFAR |
| Credential | MD |
| Practice Address |
4509 Integris Pkwy Suite 200 Edmond OK 73034-8696 |
| Mailing Address |
5300 N Independence Ave Suite 280 Oklahoma City OK 73112-5556 |
| Practice Telephone | 4056573895 |
| Practice Fax Number | 4056573896 |
| Mailing Telephone | 4056573895 |
| Mailing Fax Number | 4056573896 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2018-03-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 01072439A | IN | Other Service Providers |
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
31708 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
4509 INTEGRIS PKWY SUITE 200 |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-8696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508219577 | Victoria Stone | Physical Therapist | 4509 Integris Pkwy, Suite 100, Edmond, OK 73034-8696 | 2016-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972817054 | Scott P. Reeder | Otolaryngology | 9001 S 101st East Ave Ste 280, Tulsa, OK 74133-5711 | 2010-08-02 |
| 1356674451 | Wendy D Mcconnell | Otolaryngology | 1608 Professional Cir, Yukon, OK 73099-6314 | 2009-09-08 |
| 1285667295 | Premal Khetia | Otolaryngology | 1023 E Cherry St, Suite B, Cushing, OK 74023-4105 | 2006-07-10 |
| 1578865416 | Patrick Cody Buchanan | Otolaryngology | 800 W Boise Cir, Suite 320, Broken Arrow, OK 74012-4906 | 2010-11-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.