Individual
DR. MICHAEL SHAWN NICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O., PHARM.D.
Contact information
Practice address
1611 S UTICA AVE, STE 217, TULSA, OK 74104-4909
(918) 744-3664
(918) 748-7688
Mailing address
1611 S UTICA AVE, STE 217, TULSA, OK 74104-4909
(918) 744-3664
(918) 748-7688
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13532
OK
207L00000X
Anesthesiology Physician
Primary
4937
OK
Other
Enumeration date
06/29/2010
Last updated
05/28/2015
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