Provider Demographics
NPI:1245830439
Name:MEFFORD, MIKAYLA NEAL (PA-C)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:NEAL
Last Name:MEFFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:416 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-3108
Mailing Address - Country:US
Mailing Address - Phone:580-379-0325
Mailing Address - Fax:
Practice Address - Street 1:4411 W GORE BLVD STE A2
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5977
Practice Address - Country:US
Practice Address - Phone:580-699-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant