Individual
HEIDI MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(469) 420-5544
Mailing address
14204 N 76TH EAST AVE, COLLINSVILLE, OK 74021-4914
(918) 206-5618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
12/30/2025
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