Individual
MR. DAVID SHANNON HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 230-9000
(405) 230-9157
Mailing address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 230-9000
(405) 230-9157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2055
OK
363AS0400X
Surgical Physician Assistant
2005002890
MO
Other
Enumeration date
02/24/2006
Last updated
01/05/2018
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