Individual
MR. SHANE BRODY HNATUSKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSIV
Contact information
Practice address
744 W 9TH ST, EMERGENCY MEDICINE DEPARTMENT, TULSA, OK 74127-9020
(918) 599-5100
(918) 599-5065
Mailing address
744 W 9TH ST, EMERGENCY MEDICINE DEPARTMENT, TULSA, OK 74127-9020
(918) 599-5100
(918) 599-5065
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
05-40483
KS
Other
Enumeration date
02/18/2016
Last updated
05/31/2019
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