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General NPI Number Information
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NPI Number | 1710566088
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Entity Type | Individual
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Provider Name | MAKENNA SCHULTZ DO
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 2017 W I 35 FRONTAGE RD STE 170
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-757-3742
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Fax | 405-757-3744
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Provider Business Mailing Address
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Address Line | 2017 W I 35 FRONTAGE RD STE 170
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City | EDMOND
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State | OK
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Zip | 73013-8558
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Country | US
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Telephone | 405-757-3742
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Fax | 405-757-3744
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102207487
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License Number State | VA
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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 | 8440
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License Number State | OK
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