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Individual

TYLER SHANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 292-9530
(405) 701-7930
Mailing address
3917 CARMONA LAKES DR, MOORE, OK 73160-0012
(918) 721-1482

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
I-9469
OK
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
19177
OK

Other

Enumeration date
02/11/2021
Last updated
02/11/2026
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