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General NPI Number Information
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NPI Number | 1083005904
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Entity Type | Individual
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Provider Name | DAVID SHARRAH
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Gender | Male
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 1710 W 3RD ST STE 100
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City | ELK CITY
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State | OK
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Zip | 73644-5160
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Country | US
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Telephone | 580-339-8001
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Fax | 580-339-8031
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Provider Business Mailing Address
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Address Line | PO BOX 659506
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City | SAN ANTONIO
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State | TX
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Zip | 78265-9506
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Country | US
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Telephone | 580-339-8001
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | S60017286248
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 37661
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License Number State | OK
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