Provider Demographics
NPI:1659038412
Name:TOBIN, PAYTON EMMA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:PAYTON
Middle Name:EMMA
Last Name:TOBIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PAYTON
Other - Middle Name:EMMA
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2525 CORNWELL DR.
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099
Mailing Address - Country:US
Mailing Address - Phone:405-763-7545
Mailing Address - Fax:
Practice Address - Street 1:2525 CORNWELL DR.
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099
Practice Address - Country:US
Practice Address - Phone:405-265-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant