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Contact Information

SHANNAN L CARMOUCHE, PA
9800 BROADWAY EXTENSION
SUITE 203
OKLAHOMA CITY, OK73114
 Phone: 405-419-5412
 Fax: 405-419-5468
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Surgery

208600000X 02 Physician/General Surgery
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for SHANNAN L CARMOUCHE · (Female)

NPI # 1770560161
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 12/27/2005
Last updated 02/03/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 1162
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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