Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | R7067 | TX |
NPI | 1295969053 |
---|---|
Provider Name | Michael Loyd Megison |
First Address | Oklahoma City, OK 73104-5047 |
Second Address | Oklahoma City, OK 73104-5047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 25/09/2018 |