SHAWN FADUM

ARDMORE, OK
NPI1013374271
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: OK  2640)
Enumeration Date2016-01-19
Last Update Date2022-07-21
Business Address
-- SHAWN FADUM PA
1104 WALNUT DR
ARDMORE, OK 73401-2353
Phone number: 580-226-0543
Mailing Address
-- SHAWN FADUM PA
1104 WALNUT DR
ARDMORE, OK 73401-2353
Phone number: 580-226-0543