Individual
DR. SAMUEL SPENCER JELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
717 S HOUSTON AVE FL 3, TULSA, OK 74127-9023
(918) 382-3535
(918) 382-3559
Mailing address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425
(843) 792-0337
(843) 792-9319
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
7750
OK
2085R0202X
Diagnostic Radiology Physician
7750
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2021
Last updated
05/22/2026
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