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Individual

LEE RICHERSON MACKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
13100 N WESTERN AVE STE 303, OKLAHOMA CITY, OK 73114-1432
(800) 781-1220
(888) 678-8616
Mailing address
13100 N WESTERN AVE STE 303, OKLAHOMA CITY, OK 73114-1432
(800) 781-1220
(888) 678-8616

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5062
OK
363AS0400X
Surgical Physician Assistant
PA-508
AL

Other

Enumeration date
12/20/2006
Last updated
08/21/2023
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