Provider Demographics
NPI:1285233114
Name:SHEARWOOD, MARTIN CHANCE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CHANCE
Last Name:SHEARWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-2341
Mailing Address - Country:US
Mailing Address - Phone:918-967-3900
Mailing Address - Fax:918-967-3908
Practice Address - Street 1:909 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2341
Practice Address - Country:US
Practice Address - Phone:918-967-3900
Practice Address - Fax:918-967-3908
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor