Individual
MARC KAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1104 6TH STREET, RYAN, OK 73565
(580) 757-2451
Mailing address
PO BOX 90, INTERSECTION U.S. HWYS. 70 & 81, WAURIKA, OK 73573
(580) 228-2344
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
956
OK
363AM0700X
Medical Physician Assistant
PA-2006-0006
NM
Other
Enumeration date
06/12/2006
Last updated
09/28/2015
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