Pangburn, Samuel Jay

Pangburn, Samuel Jay is an individual health care provider with primary practice located at 10505 E 91St St Ste 203 , Tulsa OK 74133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Pangburn, Samuel Jay can be contacted via phone (918) 307-3120.

Contact Information

Primary practice address
10505 E 91St St Ste 203 Tulsa OK 74133
Phone: (918) 307-3120
Fax: (918) 307-3121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 3593 Oklahoma

Profile Details

NPI number 1922085216
LBN Legal business name Pangburn, Samuel Jay
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Mar 28th, 2023 - about 3 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 1922085216 NPPES
Oklahoma MEDICAID 100096880A
Oklahoma MEDICAID 171802501

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