Individual
DR. TERRY LYNN DEAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17675 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5492
(918) 453-5387
(918) 458-6159
Mailing address
1400 N JUNIPER PL, BROKEN ARROW, OK 74012-1540
(918) 258-6519
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17917
OK
208D00000X
General Practice Physician
R2G69
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117917
—
OK
Enumeration date
12/20/2005
Last updated
07/08/2007
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