Individual
MICHAEL SHAWN COPPOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 715-3610
Mailing address
2212 RED ELM DR, EDMOND, OK 73013-5610
(405) 850-0850
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
212739
OK
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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