Healthcare Provider Details

I. General information

NPI: 1649918087
Provider Name (Legal Business Name): MADISON SUNSHINE ROSSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON SUNSHINE GALIER PA

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4833 INTEGRIS PKWY STE 350
EDMOND OK
73034-8864
US

IV. Provider business mailing address

3001 QUAIL SPRINGS PKWY FL 5
OKLAHOMA CITY OK
73134-2640
US

V. Phone/Fax

Practice location:
  • Phone: 405-657-3690
  • Fax: 405-552-5143
Mailing address:
  • Phone: 405-657-3690
  • Fax: 405-552-5143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4840
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: