MEDICARE: ZANN MCMAHAN MD PC

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
1	332900000X	Non-Pharmacy Dispensing Site
2	207Q00000X	Family Medicine Physician	24591	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679739155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZANN MCMAHAN MD PC

Provider Business Mailing Address
First Line	:	PO BOX 31412
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-0024
Country	:	US
Telephone Number	:	405-916-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	7006 BROADWAY EXT
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-9006
Country	:	US
Telephone Number	:	405-916-4545
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	MICHAEL Z MCMAHAN
Credential	:	MD
Telephone Number	:	405-760-2018

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	01/24/2024

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