Individual
KATIE DICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20826 MAIN ST, HARRAH, OK 73045-9756
(405) 605-5415
Mailing address
PO BOX 405457, ATLANTA, GA 30384-5457
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2123
OK
Other
Enumeration date
02/13/2012
Last updated
09/22/2015
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