Healthcare Provider Details

I. General information

NPI: 1265811236
Provider Name (Legal Business Name): PAIGE MACKEY DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2015
Last Update Date: 05/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 W FARM RD
STILLWATER OK
74078-0001
US

IV. Provider business mailing address

2113 W FARM RD
STILLWATER OK
74078-0001
US

V. Phone/Fax

Practice location:
  • Phone: 405-744-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number5601
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: