Healthcare Provider Details

I. General information

NPI: 1164497780
Provider Name (Legal Business Name): SABRINA R. OLAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 RENAISSANCE BLVD
EDMOND OK
73013-3022
US

IV. Provider business mailing address

4401 W MEMORIAL RD SUITE 140
OKLAHOMA CITY OK
73134-1785
US

V. Phone/Fax

Practice location:
  • Phone: 405-844-4300
  • Fax: 408-844-4333
Mailing address:
  • Phone: 405-752-3162
  • Fax: 405-936-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19463
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: