Provider Demographics
NPI:1699659235
Name:MEG CARDONI, PHD, PLLC
Entity type:Organization
Organization Name:MEG CARDONI, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-641-4114
Mailing Address - Street 1:4717 S YORKTOWN PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4930
Mailing Address - Country:US
Mailing Address - Phone:918-808-8726
Mailing Address - Fax:
Practice Address - Street 1:2202 E 49TH ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-8714
Practice Address - Country:US
Practice Address - Phone:918-641-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center