Active NPI
University Heights Medical Clinic
- Family Medicine Physician
- Muskogee, OK
National Provider Identifier
1205474996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- UNIVERSITY HEIGHTS MEDICAL CLINIC
- Practice address
- 2901 Azalea Park Dr
Muskogee, OK 74401-2283 - Phone
- (918) 683-6500
- NPI assigned
- Dec 13, 2019
- Last updated
- Dec 13, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Byford F Shaw Jr., D.O.
- Title
- Owner
- Phone
- (918) 683-6500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
2901 Azalea Park Dr
Muskogee, OK 74401-2283
Mailing address
2901 Azalea Park Dr
Muskogee, OK 74401-2283
Phone (918) 683-6500
National Provider Directory
National Provider DirectoryLocations
2901 Azalea Park Dr
Muskogee, OK 74401
Phone (918) 683-6500
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Muskogee, OK
- NPI 1104996834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576195200000",
"number": "1205474996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 AZALEA PARK DR",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744012283",
"telephone_number": "918-683-6500",
"fax_number": "918-683-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 AZALEA PARK DR",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744012283",
"telephone_number": "918-683-6500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY HEIGHTS MEDICAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-13",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A",
"authorized_official_last_name": "SHAW",
"authorized_official_first_name": "BYFORD",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "918-683-6500",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.