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Individual

MIRANDA LOGAN PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
9625 E 108TH PL S, TULSA, OK 74133-6774
(918) 809-9364
Mailing address
7122 S SHERIDAN RD STE 2-335, TULSA, OK 74133-2748
(918) 809-9364

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4945
OK
207P00000X
Emergency Medicine Physician
E-9713
AR

Other

Enumeration date
05/24/2009
Last updated
03/14/2022
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