Individual
SAMPSON MCSIDNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14717 HOLLYHOCK DR, OKLAHOMA CITY, OK 73142
(405) 414-0091
Mailing address
14717 HOLLYHOCK DR, OKLAHOMA CITY, OK 73142
(405) 414-0091
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100719930A
—
OK
Enumeration date
09/04/2012
Last updated
09/04/2012
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