Healthcare Provider Details

I. General information

NPI: 1134688138
Provider Name (Legal Business Name): PAULA LEE SAXON OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14901 N PENNSYLVANIA AVE
OKLAHOMA CITY OK
73134-6069
US

IV. Provider business mailing address

1120 CAMBRIDGE DR
YUKON OK
73099-3329
US

V. Phone/Fax

Practice location:
  • Phone: 405-752-1200
  • Fax:
Mailing address:
  • Phone: 405-570-1417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number115
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: