Individual
MRS. MACKENCI HUDIBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(405) 271-4700
Mailing address
3808 MONTCLAIR DR, EDMOND, OK 73013-1764
(405) 488-4173
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2438
OK
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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