Healthcare Provider Details

I. General information

NPI: 1407526916
Provider Name (Legal Business Name): COURTNEY MICHELLE ACKER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S MAIN ST
SAND SPRINGS OK
74063-6509
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3333
US

V. Phone/Fax

Practice location:
  • Phone: 918-245-2286
  • Fax: 918-245-5744
Mailing address:
  • Phone: 918-245-2286
  • Fax: 918-245-5744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8585
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: