Individual
DR. CASSANDRA LEE RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10505 E 91ST ST STE 203, TULSA, OK 74133-5829
(918) 930-7312
(918) 307-3121
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 502-8210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
6637
OK
208600000X
Surgery Physician
Primary
6637
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200874640A
—
OK
Enumeration date
02/21/2018
Last updated
12/19/2023
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