Individual
DR. STACY O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7412 S YALE AVE, TULSA, OK 74136-7029
(918) 523-5437
(918) 523-5438
Mailing address
8086 S YALE AVE # 258, TULSA, OK 74136-9003
(918) 523-5437
(918) 523-5438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21759
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091570A
—
OK
Enumeration date
10/05/2005
Last updated
01/30/2014
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