Individual
SUSAN LYNNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1429 PENNSYLVANIA AVE, HARTSHORNE, OK 74547-3839
(918) 297-2403
(918) 426-0888
Mailing address
PO BOX 1992, MCALESTER, OK 74502-1992
(918) 426-2442
(918) 426-0888
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA533
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200047790A
—
OK
Enumeration date
10/16/2006
Last updated
05/02/2023
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