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NPI Code Detail

MEDICARE: LAUREN M MELOTT

MEDICARE: LAUREN M MELOTT
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
1363A00000XPhysician Assistant2925OK

General Provider Information

NPI Number : 1568958072
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN M MELOTT
Provider Business Mailing Address
First Line : 113653 OLD HIGHWAY 69
Second Line :
City : CHECOTAH
State : OK
Zip : 74426-8802
Country : US
Telephone Number : 580-565-4235
Fax Number :
Provider Business Practice Location Address
First Line : 113653 OLD HIGHWAY 69
Second Line :
City : CHECOTAH
State : OK
Zip : 74426-8802
Country : US
Telephone Number : 580-565-4235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2018
Last Update Date : 12/01/2025

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Directions to “ LAUREN M MELOTT ” Practice Location

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