Kaneaster, Shannon Kyle
Kaneaster, Shannon Kyle is an individual health care provider with primary practice located at 5701 N Portland Ave Suite 305, Oklahoma City OK 73112-1678. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kaneaster, Shannon Kyle can be contacted via phone (405) 604-4475.Contact Information
Primary practice address
5701 N Portland Ave Suite 305
Oklahoma City OK 73112-1678
Phone: (405) 604-4475
Fax: (405) 604-4480
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 22929 | Oklahoma |
Profile Details
| NPI number | 1275672529 |
|---|---|
| LBN Legal business name | Kaneaster, Shannon Kyle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Jun 1st, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275672529 | NPPES |
| Oklahoma | MEDICAID | 200172670A |
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