Provider Demographics
NPI:1700042660
Name:MORGANS, SHANNON MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:MARIE
Last Name:MORGANS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 S HARVARD AVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2925
Mailing Address - Country:US
Mailing Address - Phone:918-745-9662
Mailing Address - Fax:918-745-9663
Practice Address - Street 1:4520 S HARVARD AVE
Practice Address - Street 2:SUITE 135
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2925
Practice Address - Country:US
Practice Address - Phone:918-745-9662
Practice Address - Fax:918-745-9663
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist