Individual
MS. DANA MARIE WEATHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
503 S ASPEN AVE, BROKEN ARROW, OK 74012-2296
(918) 286-6331
(918) 806-6330
Mailing address
PO BOX 3940, BROKEN ARROW, OK 74013-3940
(918) 893-2897
(918) 893-2699
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1503
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200161920A
—
OK
Enumeration date
03/22/2007
Last updated
06/23/2016
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