=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477615060
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JILL N SPREITER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2006
-----------------------------------------------------
Last Update Date | 09/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1071 W BLUE STARR DR STE 105
-----------------------------------------------------
City | CLAREMORE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74017-2869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-341-0600
-----------------------------------------------------
Fax | 918-927-3201
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2488 E 81ST ST STE 290
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74137-4299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-927-3226
-----------------------------------------------------
Fax | 918-927-3193
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------