Healthcare Provider Details

I. General information

NPI: 1790017283
Provider Name (Legal Business Name): DANYA JULSON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12806 E 101ST PL N STE 2
OWASSO OK
74055-4662
US

IV. Provider business mailing address

12806 E 101ST PL N STE 2
OWASSO OK
74055-4662
US

V. Phone/Fax

Practice location:
  • Phone: 918-965-2236
  • Fax:
Mailing address:
  • Phone: 918-965-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5876
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: