Healthcare Provider Details

I. General information

NPI: 1821707696
Provider Name (Legal Business Name): SARALYN DYER HEFNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARALYN Y DYER PA-C

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 LIBERTY LN
EDMOND OK
73034-9432
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 405-657-3436
  • Fax: 405-815-6130
Mailing address:
  • Phone: 405-657-3436
  • Fax: 405-815-6130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4863
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: