Individual
BRIAN MICHAEL SHOCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2419 CHICKASAW BLVD, ARDMORE, OK 73401-1466
(580) 223-6767
(580) 226-2977
Mailing address
2419 CHICKASAW BLVD, ARDMORE, OK 73401-1466
(580) 223-6767
(580) 226-2977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18264
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100202500A
—
OK
Enumeration date
04/05/2006
Last updated
05/14/2008
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