Organization
TANYA S. MACLAREN, DOPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERI L YATES (CREDENTIALING MANAGER)
(580) 272-0485
Entity
Organization
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
Enumeration date
09/23/2005
Last updated
01/13/2011
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