Healthcare Provider Details

I. General information

NPI: 1548413636
Provider Name (Legal Business Name): EMILY E NAYAR P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 S 8TH ST
MCLOUD OK
74851-8633
US

IV. Provider business mailing address

704 S 8TH ST P.O. BOX 530
MCLOUD OK
74851-8633
US

V. Phone/Fax

Practice location:
  • Phone: 405-964-6463
  • Fax: 405-964-2412
Mailing address:
  • Phone: 405-964-6463
  • Fax: 405-964-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1769
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1769
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: