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Michael Shawn Coppock

Nurse Anesthetist, Certified Registered in Oklahoma City, OK. Individual provider (NPI-1).

NPI number1104516210
StatusActive
Last updated in NPPESMay 11, 2023

Details

NPI
1104516210
Entity type
Individual (NPI-1)
Name
Michael Shawn Coppock
Sex
Male
Sole proprietor
Yes
Enumeration date
May 11, 2023
Certification date
May 11, 2023
Last updated
May 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered212739OKYes

Practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Phone 405-715-3610

Mailing address

2212 Red Elm Dr
Edmond, OK 73013-5610

Phone 405-850-0850

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