Healthcare Provider Details

I. General information

NPI: 1861320004
Provider Name (Legal Business Name): SUMMER BOYNTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7477 E 46TH PL
TULSA OK
74145-6305
US

IV. Provider business mailing address

7477 E 46TH PL
TULSA OK
74145-6305
US

V. Phone/Fax

Practice location:
  • Phone: 918-384-0002
  • Fax:
Mailing address:
  • Phone: 918-384-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: