DAGENAIS & ASSOCIATES MEDICAL CLINIC LLC NPI 1043618572

NPI Information

NPI: 1043618572
Provider Name: DAGENAIS & ASSOCIATES MEDICAL CLINIC, LLC
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

CLIA Number: 37D2087563

Address:
137 EAST MAIN
PAWHUSKA, OK
ZIP 74056
Phone: (918) 217-8696
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DAGENAIS & ASSOCIATES MEDICAL CLINIC, LLC is a medical physician assistant in Pawhuska, OK. DAGENAIS & ASSOCIATES MEDICAL CLINIC, LLC NPI is 1043618572. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

137 EAST MAIN
PAWHUSKA, OK
ZIP 74056
Phone: (918) 217-8696
Fax: (918) 217-8696

The provider's authorized official is Mary Jane Dagenais .
The authorized official title is Owner and has the following contact phone number (918) 217-8696.

The CLIA number assigned to this NPI record is 37D2087563 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2014 and was last updated on 3/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	1218	OKLAHOMA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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