Search › Oklahoma › 171M00000X
Ethan Birdwell
NPI 1457077190 · on the registry since 2022
Practice
- Address
- 1202 Monroe Dr
Shawnee, OK 74804 - Phone
- (405) 517-3806
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-10-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma