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Individual

SUSAN MOORE CORKRAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1413 S WESTERN RD, STILLWATER, OK 74074-6957
(405) 533-2844
(405) 533-4035
Mailing address
1413 S WESTERN RD, STILLWATER, OK 74074-6957
(405) 533-2844
(405) 533-4035

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16743
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100033910A
OK
01
16743
MEDICAL LICENSE
OK
Enumeration date
07/25/2006
Last updated
09/03/2008
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