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General NPI Number Information
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NPI Number | 1992641815
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Entity Type | Individual
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Provider Name | INA MAHONEY
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Gender | Female
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 715 NW 50TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-6207
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Country | US
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Telephone | 405-843-1501
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Fax | 405-843-1332
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Provider Business Mailing Address
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Address Line | 14025 N EASTERN AVE APT 3002
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City | EDMOND
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State | OK
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Zip | 73013-3521
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Country | US
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Telephone | 405-922-5025
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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 | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | I-10754
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License Number State | OK
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