Individual
RAY SHOFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 ROCKEFELLER DR, MUSKOGEE, OK 74401-5075
(405) 947-5557
(405) 948-6507
Mailing address
PO BOX 1664, MUSKOGEE, OK 74402-1664
(405) 947-5557
(405) 948-6507
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0033822
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731521875001
BC/BS OF OK
OK
Enumeration date
09/05/2006
Last updated
07/08/2007
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