Individual
SONJA JANET BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-0123
(918) 293-3184
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-0123
(918) 293-3184
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1190
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00164929
RR MEDICARE
OK
Enumeration date
04/28/2006
Last updated
07/08/2007
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