Provider Demographics
NPI:1487695763
Name:ADKINS, SHELDON DEAN (MED)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:DEAN
Last Name:ADKINS
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6370
Mailing Address - Country:US
Mailing Address - Phone:405-642-6811
Mailing Address - Fax:
Practice Address - Street 1:2501 E MEMORIAL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5525
Practice Address - Country:US
Practice Address - Phone:405-425-5250
Practice Address - Fax:405-425-5251
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional