Individual
MELINDA DANDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
410 E MAIN ST, JENKS, OK 74037-4135
(918) 298-5437
(918) 298-5438
Mailing address
410 E MAIN ST, JENKS, OK 74037-4135
(918) 298-5437
(918) 298-5438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3942
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200037860A
—
OK
05
—
200037860B
—
OK
Enumeration date
06/22/2005
Last updated
07/10/2008
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