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General NPI Number Information
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NPI Number | 1366373300
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Entity Type | Organization
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Legal Business Name | OKLAHOMA SHOULDER SURGERY, LLC
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 12806 E 101ST PL N STE 2
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City | OWASSO
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State | OK
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Zip | 74055-4662
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Country | US
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Telephone | 918-965-2236
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Fax |
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Provider Business Mailing Address
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Address Line | 1175 S ASPEN AVE STE K
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City | BROKEN ARROW
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State | OK
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Zip | 74012-4800
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Country | US
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Telephone | 833-524-2400
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Fax | 918-290-4943
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Authorized Official
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Title or Position | PHYSICIAN/MEMBER
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Name | DANYA J JULSON
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Credential |
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Telephone | 918-798-4802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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