Individual
KIM MCLANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5105 CIRCLE GLEN, EDMOMD, OK 73025
(405) 341-7006
Mailing address
5105 CIRCLE GLN, EDMOND, OK 73003-2811
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
15838
OK
208D00000X
General Practice Physician
Primary
15838
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39404
OBNDD
OK
Enumeration date
02/28/2007
Last updated
04/02/2010
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