Healthcare Provider Details

I. General information

NPI: 1386362184
Provider Name (Legal Business Name): KARLI MATHIS SPANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

800 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104-5018
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4700
  • Fax:
Mailing address:
  • Phone: 405-271-2316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number47860
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: