Healthcare Provider Details

I. General information

NPI: 1376476614
Provider Name (Legal Business Name): SARAH N BOX PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH N STOUT

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SW 89TH ST
OKLAHOMA CITY OK
73139-9104
US

IV. Provider business mailing address

2610 NW 42ND ST
OKLAHOMA CITY OK
73112-3712
US

V. Phone/Fax

Practice location:
  • Phone: 405-814-3400
  • Fax:
Mailing address:
  • Phone: 405-761-6599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5887
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: