Provider Demographics
NPI:1215922042
Name:ADAM G SHERMAN PHD PC
Entity type:Organization
Organization Name:ADAM G SHERMAN PHD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-712-2885
Mailing Address - Street 1:3015 E SKELLY DR
Mailing Address - Street 2:SUITE 135
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6317
Mailing Address - Country:US
Mailing Address - Phone:918-712-2885
Mailing Address - Fax:918-712-9019
Practice Address - Street 1:3015 E SKELLY DR
Practice Address - Street 2:SUITE 135
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6317
Practice Address - Country:US
Practice Address - Phone:918-712-2885
Practice Address - Fax:918-712-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK771103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK073461769001OtherBLUE CROSS BLUE SHIELD
OK073461769001OtherBLUE CROSS BLUE SHIELD