Individual
TANYA S MACLAREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3048 SW 89TH ST, STE A, OKLAHOMA CITY, OK 73159-6359
(580) 272-0485
(580) 332-5750
Mailing address
PO BOX 108810, OKLAHOMA CITY, OK 73101-8810
(580) 272-0485
(580) 332-5750
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3587
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100189620A
—
OK
01
—
175779900
DEPT OF LABOR
OK
01
—
731611350001
BCBS OF OK
OK
01
—
7437254
AETNA
OK
Enumeration date
10/12/2005
Last updated
01/13/2011
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