Individual
DR. JASON TYLER STANSILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3960 S HUDSON AVE, TULSA, OK 74135-5608
(918) 984-9378
(918) 984-9379
Mailing address
3960 S HUDSON AVE, TULSA, OK 74135-5608
(918) 984-9378
(918) 984-9379
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22433
OK
207R00000X
Internal Medicine Physician
7046A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200118170A
—
OK
Enumeration date
06/11/2006
Last updated
05/31/2016
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