Basic Information
Provider Information
NPI: 1003012840
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHAW-DRESSLER
FirstName: SARAH
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6600 S YALE AVE STE 1200
Address2:  
City: TULSA
State: OK
PostalCode: 741363333
CountryCode: US
TelephoneNumber: 9184886687
FaxNumber: 9184886098
Practice Location
Address1: 6151 S YALE AVE STE 100A
Address2:  
City: TULSA
State: OK
PostalCode: 741361929
CountryCode: US
TelephoneNumber: 9184948500
FaxNumber: 9183075578
Other Information
ProviderEnumerationDate: 06/26/2007
LastUpdateDate: 09/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X5101017367MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X6111OKY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000XOS016441PAN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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