O'Sullivan, Stacy

O'Sullivan, Stacy is an individual health care provider with primary practice located at 7412 S Yale Ave , Tulsa OK 74136-7029. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. O'Sullivan, Stacy can be contacted via phone (918) 523-5437.

Contact Information

Primary practice address
7412 S Yale Ave Tulsa OK 74136-7029
Phone: (918) 523-5437
Fax: (918) 523-5438
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 21759 Oklahoma

Profile Details

NPI number 1457348344
LBN Legal business name O'Sullivan, Stacy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Jan 30th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457348344 NPPES
Oklahoma MEDICAID 100091570A

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