Healthcare Provider Details

I. General information

NPI: 1255545778
Provider Name (Legal Business Name): HEATHER B SUMMERS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 S YALE AVE SUITE 610
TULSA OK
74136-8378
US

IV. Provider business mailing address

6565 S YALE AVE SUITE 610
TULSA OK
74136-8378
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-2200
  • Fax: 918-502-2210
Mailing address:
  • Phone: 918-502-2200
  • Fax: 918-502-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER B SUMMERS
Title or Position: OWNER
Credential: MD
Phone: 918-502-2200