# ST JOHN SAPULPA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225284771
- **Authorized official:** MRS. DONNA SUE NAGEL (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (918) 224-4280

## Contact information

- **Practice address:** 1004 E BRYAN, SAPULPA, OK 74066-1368
- **Practice address phone:** (918) 224-4280
- **Practice address fax:** (918) 224-6290
- **Mailing address:** 1004 E BRYAN, SAPULPA, OK 74066-1368
- **Mailing address phone:** (918) 224-4280
- **Mailing address fax:** (918) 224-6290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2310 | OK | Yes |

## Other

- **Enumeration date:** 08/15/2008
- **Last updated:** 08/19/2008