Individual
SYEACHIA NYREAHRI DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1334 N. LANSING AVE., TULSA, OK 74106-5907
(918) 587-2171
(918) 295-6149
Mailing address
1334 N LANSING AVE, TULSA, OK 74106-5907
(918) 587-2171
(918) 295-6149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26928
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100768880I
—
OK
01
—
1275528085
MORTON MAIN CLINIC NPI NUMBER
OK
05
—
200234130A
—
OK
05
—
J23117858
—
OK
01
—
WCDPG
MEDICARE
OK
Enumeration date
05/08/2007
Last updated
08/19/2009
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