Healthcare Provider Details

I. General information

NPI: 1982195673
Provider Name (Legal Business Name): MEREDITH LEIGH DUNN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 07/06/2023
Certification Date: 11/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 NW 56TH ST STE 950
OKLAHOMA CITY OK
73112
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US

V. Phone/Fax

Practice location:
  • Phone: 405-713-9940
  • Fax: 405-713-9941
Mailing address:
  • Phone: 405-713-9940
  • Fax: 405-713-9941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2926
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: