Healthcare Provider Details

I. General information

NPI: 1518946326
Provider Name (Legal Business Name): MARGARET ELLA MEREDITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113653 OLD HIGHWAY 69
CHECOTAH OK
74426-8802
US

IV. Provider business mailing address

36488 S HIGHWAY 82
VINITA OK
74301-7438
US

V. Phone/Fax

Practice location:
  • Phone: 580-565-4235
  • Fax:
Mailing address:
  • Phone: 918-788-1881
  • Fax: 918-782-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1057
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: