Provider Demographics
NPI:1467671578
Name:SHOUN, SHELLEY DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:DAWN
Last Name:SHOUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8001
Practice Address - Street 1:6465 S YALE AVE STE 815
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7820
Practice Address - Country:US
Practice Address - Phone:918-502-4848
Practice Address - Fax:918-502-4850
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24064207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200192440AMedicaid