Healthcare Provider Details

I. General information

NPI: 1598307688
Provider Name (Legal Business Name): MADISON ELIZABETH POINTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 E 41ST ST STE 900
TULSA OK
74135-5631
US

IV. Provider business mailing address

4325 S MADISON PL
TULSA OK
74105-3968
US

V. Phone/Fax

Practice location:
  • Phone: 918-934-8347
  • Fax: 918-743-8552
Mailing address:
  • Phone: 918-829-9637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4764
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: