Provider Demographics
NPI:1538769005
Name:STANFORD, SHAWN J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:J
Last Name:STANFORD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4381
Mailing Address - Country:US
Mailing Address - Phone:405-515-7423
Mailing Address - Fax:405-515-7420
Practice Address - Street 1:2551 CLASSEN BLVD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4381
Practice Address - Country:US
Practice Address - Phone:405-515-7423
Practice Address - Fax:405-515-7420
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK14995Other14995