Healthcare Provider Details

I. General information

NPI: 1407346315
Provider Name (Legal Business Name): EMILY CAHILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SW 44TH ST
OKLAHOMA CITY OK
73109-3540
US

IV. Provider business mailing address

3000 N GRAND BLVD
OKLAHOMA CITY OK
73107-1818
US

V. Phone/Fax

Practice location:
  • Phone: 405-632-6688
  • Fax:
Mailing address:
  • Phone: 405-632-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6627
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: