Individual
PAIGE ELIZABETH BEVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13100 N WESTERN AVE STE 301, OKLAHOMA CITY, OK 73114-1432
(405) 947-6647
Mailing address
13100 N WESTERN AVE STE 301, OKLAHOMA CITY, OK 73114-1432
(405) 947-6647
(405) 948-6647
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
PA2646
OK
363A00000X
Physician Assistant
2646
OK
363AM0700X
Medical Physician Assistant
2646
OK
Other
Enumeration date
01/15/2016
Last updated
10/17/2018
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