Healthcare Provider Details

I. General information

NPI: 1780506311
Provider Name (Legal Business Name): DR. KENNEDY PAIGE MCCLAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11300 N GARNETT RD
OWASSO OK
74055-4258
US

IV. Provider business mailing address

13343 N 131ST EAST AVE
COLLINSVILLE OK
74021-4395
US

V. Phone/Fax

Practice location:
  • Phone: 918-516-1919
  • Fax: 539-664-7792
Mailing address:
  • Phone: 918-344-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6772
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: