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Individual

MRS. MONIQUE TISHA MODEST-MCKOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3400 E FRANK PHILLIPS BLVD STE 400, BARTLESVILLE, OK 74006-2440
(183) 312-5339
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 403-7066
(918) 744-2946

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29720
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200489990A
OK
Enumeration date
04/21/2009
Last updated
03/18/2025
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