Individual
MARY GODINICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11011 HEFNER POINTE DR STE A, OKLAHOMA CITY, OK 73120-5005
(405) 479-8300
Mailing address
945 NE 16TH ST, OKLAHOMA CITY, OK 73104-4609
(405) 623-7848
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5689
OK
Other
Enumeration date
09/26/2024
Last updated
01/09/2026
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