Healthcare Provider Details

I. General information

NPI: 1538522875
Provider Name (Legal Business Name): COURTNEY SAULS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S HOUSTON AVE 4TH FLOOR
TULSA OK
74127-9023
US

IV. Provider business mailing address

1919 S WHEELING AVE STE 304
TULSA OK
74104-5632
US

V. Phone/Fax

Practice location:
  • Phone: 918-382-3100
  • Fax:
Mailing address:
  • Phone: 918-794-7337
  • Fax: 918-403-6438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6249
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: