Provider Demographics
NPI:1326536871
Name:MEEHAN, CAMILLE (DO)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S WHEELING AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5462
Mailing Address - Country:US
Mailing Address - Phone:918-747-9641
Mailing Address - Fax:918-746-2252
Practice Address - Street 1:2000 S WHEELING AVE STE 800
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5462
Practice Address - Country:US
Practice Address - Phone:918-747-9641
Practice Address - Fax:918-746-2252
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK6706207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program