Individual
MRS. SHANNON WHITNEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
600 S MONROE ST, ENID, OK 73701-7211
(580) 233-2300
Mailing address
5833 HUERFANO DR, COLORADO SPRINGS, CO 80923-3436
(316) 573-3088
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4606
OK
363AM0700X
Medical Physician Assistant
4606
OK
Other
Enumeration date
07/14/2021
Last updated
09/30/2021
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