Healthcare Provider Details

I. General information

NPI: 1376022673
Provider Name (Legal Business Name): MEGAN ELIZABETH CAMPBELL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 01/20/2020
Certification Date: 01/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12326 E 86TH ST N
OWASSO OK
74055-2543
US

IV. Provider business mailing address

PO BOX 721628
NORMAN OK
73070-8250
US

V. Phone/Fax

Practice location:
  • Phone: 918-272-3750
  • Fax: 918-272-1923
Mailing address:
  • Phone: 405-809-8712
  • Fax: 405-573-6768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: