Individual
SHAWN MICHAEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4345 W MEMORIAL RD STE 110, OKLAHOMA CITY, OK 73134-1717
(405) 418-7000
Mailing address
4401 W MEMORIAL RD, 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
04757
OK
208VP0014X
Interventional Pain Medicine Physician
Primary
04757
OK
Other
Enumeration date
06/13/2008
Last updated
05/09/2014
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