Provider Demographics
NPI:1881793859
Name:HUTCHERSON, MEGAN L (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:L
Last Name:HUTCHERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 HEALTHPLEX PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9801
Mailing Address - Country:US
Mailing Address - Phone:405-515-2222
Mailing Address - Fax:
Practice Address - Street 1:3500 HEALTHPLEX PKWY STE 200
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9801
Practice Address - Country:US
Practice Address - Phone:405-515-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1328363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK354139YVJDOtherMEDICARE PTAN
OK200218690AMedicaid
OKQ20836Medicare UPIN
OK200218690AMedicaid