Provider Demographics
NPI:1952726259
Name:GIBSON, MEGAN CATHLEEN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CATHLEEN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:CATHLEEN
Other - Last Name:HADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:512 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CASHION
Mailing Address - State:OK
Mailing Address - Zip Code:73016-9441
Mailing Address - Country:US
Mailing Address - Phone:405-863-7500
Mailing Address - Fax:
Practice Address - Street 1:512 N 3RD ST
Practice Address - Street 2:
Practice Address - City:CASHION
Practice Address - State:OK
Practice Address - Zip Code:73016-9441
Practice Address - Country:US
Practice Address - Phone:405-863-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-23
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator