Provider Demographics
NPI:1447571294
Name:KOOMSON, MEREDITH MCKEE (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MCKEE
Last Name:KOOMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ALLISON
Other - Last Name:MCKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 NW EXPRESSWAY STE 500
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4492
Mailing Address - Country:US
Mailing Address - Phone:405-945-4805
Mailing Address - Fax:059-454-8034
Practice Address - Street 1:3400 NW EXPRESSWAY STE 500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4492
Practice Address - Country:US
Practice Address - Phone:405-945-4805
Practice Address - Fax:405-945-4803
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76589207R00000X
OK29891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine