Grant, Shawn D

Grant, Shawn D is an individual health care provider with primary practice located at 1120 S Utica Ave , Tulsa OK 74104-4012. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Grant, Shawn D can be contacted via phone (918) 579-7720.

Contact Information

Primary practice address
1120 S Utica Ave Tulsa OK 74104-4012
Phone: (918) 579-7720
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 38822 Kentucky
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 38822 Kentucky

Profile Details

NPI number 1043214497
LBN Legal business name Grant, Shawn D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jan 30th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043214497 NPPES
Indiana MEDICAID 200513800
Indiana MEDICAID 64110307

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