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Individual

MICHAEL SHACKELFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.N.,BSN

Contact information

Practice address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
Mailing address
2425 OSBORNE DR, NORMAN, OK 73069-5026
(405) 329-2404

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0060494
OK

Other

Enumeration date
08/16/2006
Last updated
07/08/2007
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