Provider Demographics
NPI:1225257447
Name:SHARP, BILLY JOE JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:JOE
Last Name:SHARP
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11208 LAKERIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-2455
Mailing Address - Country:US
Mailing Address - Phone:405-692-3008
Mailing Address - Fax:405-692-3008
Practice Address - Street 1:1300 MCGEE DR
Practice Address - Street 2:STE. 104
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-5774
Practice Address - Country:US
Practice Address - Phone:405-369-4433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical