Provider Demographics
NPI:1346280641
Name:SHIELDS, GEORGE S (OD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:S
Last Name:SHIELDS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-7015
Mailing Address - Country:US
Mailing Address - Phone:405-749-8300
Mailing Address - Fax:405-749-8307
Practice Address - Street 1:3545 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-7015
Practice Address - Country:US
Practice Address - Phone:405-749-8300
Practice Address - Fax:405-749-8307
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2350152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist