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NPI Code Detail

MEDICARE: DR. AMBER LEE SHIPMAN MD, FAAP

MEDICARE: DR. AMBER LEE SHIPMAN MD, FAAP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician30740OK
22080C0008XChild Abuse Pediatrics Physician

General Provider Information

NPI Number : 1346660834
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMBER LEE SHIPMAN MD, FAAP
Provider Business Mailing Address
First Line : 12512 E 21ST ST
Second Line :
City : TULSA
State : OK
Zip : 74129-1806
Country : US
Telephone Number : 918-591-3969
Fax Number : 405-703-0645
Provider Business Practice Location Address
First Line : 12512 E 21ST ST
Second Line :
City : TULSA
State : OK
Zip : 74129-1806
Country : US
Telephone Number : 918-591-3969
Fax Number : 405-703-0645
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2014
Last Update Date : 12/05/2025

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