Individual
SHANNON MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1208 W 15TH ST, EDMOND, OK 73013-3001
(405) 340-2100
(405) 340-1184
Mailing address
530 N MONTE VISTA, SUITE A, ADA, OK 74820-4675
(580) 436-7101
(580) 436-4447
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1614
OK
Other
Enumeration date
06/26/2008
Last updated
11/26/2014
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