MEDICARE: OKLAHOMA SLEEP & WELLNESS CLINIC, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1073408001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA SLEEP & WELLNESS CLINIC, PLLC

Provider Business Mailing Address
First Line	:	5350 S WESTERN AVE STE 315
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109-4530
Country	:	US
Telephone Number	:	405-777-2727
Fax Number	:	405-953-8153

Provider Business Practice Location Address
First Line	:	5350 S WESTERN AVE STE 315
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109-4530
Country	:	US
Telephone Number	:	405-831-6965
Fax Number	:	405-953-8153

Authorized Official
Title or Position	:	MEDICAL ASSISTANT
Name	:	HEATHER GREGG
Credential	:	MA
Telephone Number	:	918-290-0374

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	10/01/2025

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