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General NPI Number Information
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NPI Number | 1710064209
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Entity Type | Individual
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Provider Name | MICHAEL ZANN MCMAHAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 7006 BROADWAY EXT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-9006
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Country | US
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Telephone | 405-916-4545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31412
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City | EDMOND
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State | OK
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Zip | 73003-0024
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Country | US
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Telephone | 405-916-4545
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 24591
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24591
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License Number State | OK
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