Provider Demographics
NPI:1386609923
Name:JAMES, SHIRLEY A
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:A
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N PHILLIPS AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4619
Mailing Address - Country:US
Mailing Address - Phone:405-271-3625
Mailing Address - Fax:405-271-1707
Practice Address - Street 1:1600 N PHILLIPS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4619
Practice Address - Country:US
Practice Address - Phone:405-271-3625
Practice Address - Fax:405-271-1707
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK 1156225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist