Healthcare Provider Details

I. General information

NPI: 1437093259
Provider Name (Legal Business Name): MADISON PAIGE DUGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 S ASPEN AVE
BROKEN ARROW OK
74011-1519
US

IV. Provider business mailing address

4200 S ASPEN AVE
BROKEN ARROW OK
74011-1519
US

V. Phone/Fax

Practice location:
  • Phone: 918-517-8544
  • Fax:
Mailing address:
  • Phone: 918-517-8544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4710
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: