Provider Demographics
NPI:1730077678
Name:SEDGWICK, MADELINE JESSOP
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:JESSOP
Last Name:SEDGWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADDIE
Other - Middle Name:JESSOP
Other - Last Name:SEDGWICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1625 N DONALD AVE APT 154
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-8056
Mailing Address - Country:US
Mailing Address - Phone:405-323-4233
Mailing Address - Fax:
Practice Address - Street 1:2000 N CLASSEN BLVD STE 2600
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6027
Practice Address - Country:US
Practice Address - Phone:405-248-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist