Roark, Sally Marie

Roark, Sally Marie is an individual health care provider with primary practice located at 3400 W Tecumseh Rd Ste 101 , Norman OK 73072-1810. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Roark, Sally Marie can be contacted via phone (405) 360-6764.

Contact Information

Primary practice address
3400 W Tecumseh Rd Ste 101 Norman OK 73072-1810
Phone: (405) 360-6764
Fax: (405) 360-6769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1239 Oklahoma

Profile Details

NPI number 1952368961
LBN Legal business name Roark, Sally Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Feb 28th, 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 1952368961 NPPES
Oklahoma Other 970030418 RAILROAD MEDICARE
Oklahoma MEDICAID 200006210A RAILROAD MEDICARE

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