Provider Demographics
NPI:1497927511
Name:ANTHONY, KERRI DIONE (MD)
Entity Type:Individual
Prefix:DR
First Name:KERRI
Middle Name:DIONE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:DIONE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4140 W MEMORIAL RD
Mailing Address - Street 2:SUITE 321
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8366
Mailing Address - Country:US
Mailing Address - Phone:405-286-5600
Mailing Address - Fax:405-607-2711
Practice Address - Street 1:4140 W MEMORIAL RD
Practice Address - Street 2:SUITE 321
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8366
Practice Address - Country:US
Practice Address - Phone:405-286-5600
Practice Address - Fax:405-607-2711
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26186207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200201910AMedicaid
OK200201910AMedicaid