Individual
ALISON MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5156
OK
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/04/2024
Last updated
10/14/2024
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