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Individual

KIZZY LANAE MCCASKILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3400 W TECUMSEH RD, SUITE 203, NORMAN, OK 73072-1811
(405) 307-5720
(405) 307-5721
Mailing address
PO BOX 1330, NORMAN, OK 73070-1330
(405) 307-5720
(405) 307-5721

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1806
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200259700A
OK
Enumeration date
03/02/2009
Last updated
04/18/2012
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