Individual
DR. ERNESTINE CAROL SHIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3325 S BOULEVARD STE 113, EDMOND, OK 73013-4812
(405) 330-7000
Mailing address
601 S HARBOUR ISLAND BLVD STE 200, TAMPA, FL 33602-5925
(800) 480-5243
(800) 928-7449
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16913
OK
208600000X
Surgery Physician
16913
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100103000A
—
OK
Enumeration date
05/15/2012
Last updated
07/31/2024
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