Healthcare Provider Details

I. General information

NPI: 1528684107
Provider Name (Legal Business Name): ELIZABETH NANA AMA SARPORMA OSEI-KUFFUOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date: 01/17/2022
Reactivation Date: 02/02/2022

III. Provider practice location address

1200 CHILDRENS AVE STE 6A
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

1200 CHILDRENS AVE STE 6A
OKLAHOMA CITY OK
73104-4637
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6827
  • Fax: 405-271-2573
Mailing address:
  • Phone: 405-271-6827
  • Fax: 405-271-2573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number47499
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: