Healthcare Provider Details

I. General information

NPI: 1275465593
Provider Name (Legal Business Name): MRS. MEGAN O GUTHRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 N 4TH ST
STILWELL OK
74960-2417
US

IV. Provider business mailing address

472628 E 680 RD
WESTVILLE OK
74965-5424
US

V. Phone/Fax

Practice location:
  • Phone: 918-696-6212
  • Fax:
Mailing address:
  • Phone: 918-868-7193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: