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Organization

K ANTHONY SHANBOUR, M.D., INC

Active
Other names
SHANBOUR & GOFF ASSOCIATES
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY S HORN CPC (INSURANCE CORDINATOR)
(405) 242-4036
Entity
Organization

Contact information

Practice address
4140 W MEMORIAL RD, SUITE 215, OKLAHOMA CITY, OK 73120
(405) 242-4030
(405) 242-4031
Mailing address
4140 W MEMORIAL RD, SUITE 215, OKLAHOMA CITY, OK 73120
(405) 242-4030
(405) 242-4031

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17067
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
441609746002
BLUE CROSS BLUE SHEILD
OK
Enumeration date
10/10/2006
Last updated
08/22/2020
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