Provider Demographics
NPI:1417752387
Name:SHIBLEY, SIDNEY KAY (DC)
Entity type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:KAY
Last Name:SHIBLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E 140TH PL
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-3117
Mailing Address - Country:US
Mailing Address - Phone:918-340-8836
Mailing Address - Fax:
Practice Address - Street 1:3345 S HARVARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-1800
Practice Address - Country:US
Practice Address - Phone:918-743-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4650111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation