Healthcare Provider Details

I. General information

NPI: 1558408138
Provider Name (Legal Business Name): JULIE ANN SIGL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 S 8TH ST
HEALDTON OK
73438-2424
US

IV. Provider business mailing address

918 S 8TH ST
HEALDTON OK
73438-2424
US

V. Phone/Fax

Practice location:
  • Phone: 580-229-0701
  • Fax:
Mailing address:
  • Phone: 580-229-0701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1260
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: