Unknown Individual – Physician Assistant, NPI 1487774618
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
13616 E 103RD ST N
STE A
OWASSO, OK 740554586
Phone: (918) 274-8555
Fax: (918) 274-8556
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74055)
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