Provider Demographics
NPI:1104825231
Name:SHEARER, CHRISTOPHER A (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:SHEARER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:A
Other - Last Name:SHEARER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:580-977-1844
Mailing Address - Fax:580-234-5176
Practice Address - Street 1:915 E GARRIOTT RD
Practice Address - Street 2:SUITE C
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6156
Practice Address - Country:US
Practice Address - Phone:580-234-6425
Practice Address - Fax:580-234-5176
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100137670COtherMEDICAID OSU
OK100137670BMedicaid
OKP01318479OtherRR MEDICARE
OK100137670COtherMEDICAID OSU
OK100137670BMedicaid