Individual
JULIE BLIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4334
Mailing address
4502 E 41ST ST, TULSA, OK 74135-2536
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6237
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200652270B
—
OK
Enumeration date
04/04/2016
Last updated
10/31/2019
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