Healthcare Provider Details

I. General information

NPI: 1174499107
Provider Name (Legal Business Name): SEISMIC HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 E 31ST ST
TULSA OK
74135-1500
US

IV. Provider business mailing address

3540 E 31ST ST
TULSA OK
74135-1500
US

V. Phone/Fax

Practice location:
  • Phone: 918-984-4240
  • Fax:
Mailing address:
  • Phone: 918-984-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON WARNER SIMS
Title or Position: OWNER/PHYSICIAN
Credential:
Phone: 918-519-7711