Individual
JUDY A DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9423 E 95TH CT, TULSA, OK 74133-5805
(918) 496-2400
(918) 496-2436
Mailing address
9423 E 95TH CT, TULSA, OK 74133-5805
(918) 496-2400
(405) 948-6507
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2161
OK
Other
Enumeration date
04/11/2006
Last updated
10/26/2007
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