Individual
SAMPSON J BLYTHE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
312 S BROADWAY, CLEVELAND, OK 74020
(918) 358-3376
(918) 358-3376
Mailing address
312 S BROADWAY, CLEVELAND, OK 74020
(918) 358-3376
(918) 358-3376
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2247
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100829970A
—
OK
01
—
731237629001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
03/29/2007
Last updated
08/07/2012
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