Healthcare Provider Details

I. General information

NPI: 1073545380
Provider Name (Legal Business Name): TERRY JEAN STYLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S UTICA AVE
TULSA OK
74104-4012
US

IV. Provider business mailing address

1120 S UTICA AVE
TULSA OK
74104-4012
US

V. Phone/Fax

Practice location:
  • Phone: 918-579-8200
  • Fax: 918-579-8204
Mailing address:
  • Phone: 615-746-1662
  • Fax: 615-296-0952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD422515
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: