Provider Demographics
NPI:1649320334
Name:SCHLECHT, MARJORIE MARY (PAC)
Entity type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:MARY
Last Name:SCHLECHT
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:PO BOX 1069
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-1069
Mailing Address - Country:US
Mailing Address - Phone:405-224-8111
Mailing Address - Fax:405-222-5359
Practice Address - Street 1:2222 W IOWA AVE
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2738
Practice Address - Country:US
Practice Address - Phone:405-224-8111
Practice Address - Fax:405-222-5359
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1073363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073OtherLICENSE NUMBER
OK28924OtherBNDD