Provider Demographics
NPI:1083127823
Name:METHENY, MICAH STEVEN (PA)
Entity Type:Individual
Prefix:
First Name:MICAH
Middle Name:STEVEN
Last Name:METHENY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:200 S ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-8727
Mailing Address - Country:US
Mailing Address - Phone:405-282-6700
Mailing Address - Fax:405-282-6790
Practice Address - Street 1:200 S ACADEMY RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-8727
Practice Address - Country:US
Practice Address - Phone:405-282-6700
Practice Address - Fax:405-282-6790
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2022-06-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant