Provider Demographics
NPI:1881756229
Name:SCHEFF-PAUL, TAMMY MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:MARIE
Last Name:SCHEFF-PAUL
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 1:317 E AQUARIUM PL
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-6811
Mailing Address - Country:US
Mailing Address - Phone:918-296-4733
Mailing Address - Fax:918-417-7661
Practice Address - Street 1:317 E AQUARIUM PL
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-6811
Practice Address - Country:US
Practice Address - Phone:918-296-4733
Practice Address - Fax:918-417-7661
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK2205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200528520AMedicaid
OK200004890AMedicaid
OK238312301Medicare Oscar/Certification
OK3171770001Medicare NSC