Individual
DR. DARIN MICHAEL SHUPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
124 SE AVE N, IDABEL, OK 74745-5234
(580) 286-2020
(580) 286-2305
Mailing address
124 SE AVE N, IDABEL, OK 74745-5234
(580) 286-2020
(580) 286-2305
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2082
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100765040A
—
OK
Enumeration date
10/11/2006
Last updated
05/19/2010
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