Individual
MRS. MARY KAY DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1809 E 13TH ST STE 200, TULSA, OK 74104-4431
(918) 579-2300
Mailing address
1809 E 13TH ST STE 200, TULSA, OK 74104-4431
(918) 579-2300
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4776
OK
Other
Enumeration date
09/08/2021
Last updated
08/11/2025
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