Organization
SHOCKEY INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MICHAEL SHOCKEY MD (OWNER)
(580) 223-6767
Entity
Organization
Contact information
Practice address
2419 CHICKASAW BLVD, ARDMORE, OK 73401-1466
(580) 223-6767
(580) 224-0275
Mailing address
2419 CHICKASAW BLVD, ARDMORE, OK 73401-1466
(580) 223-6767
(580) 224-0275
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
12/15/2006
Last updated
05/15/2008
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