Healthcare Provider Details

I. General information

NPI: 1215477435
Provider Name (Legal Business Name): REBEKAH JEAN MARTIN KRIEGSMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEKAH JEAN MARTIN

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S 40TH ST
MUSKOGEE OK
74401-4915
US

IV. Provider business mailing address

6600 S YALE AVE STE 1400
TULSA OK
74136-3331
US

V. Phone/Fax

Practice location:
  • Phone: 918-684-2663
  • Fax: 918-681-6804
Mailing address:
  • Phone: 918-499-4855
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6435
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: