Provider Demographics
NPI:1568470979
Name:SHUEY, STEPHEN C (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:SHUEY
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 1:817 S ELM PL
Mailing Address - Street 2:STE 107
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-5369
Mailing Address - Country:US
Mailing Address - Phone:918-251-5588
Mailing Address - Fax:918-251-5658
Practice Address - Street 1:817 S ELM PL
Practice Address - Street 2:STE 107
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5369
Practice Address - Country:US
Practice Address - Phone:918-251-5588
Practice Address - Fax:918-251-5658
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T75299Medicare ID - Type Unspecified