MEDICARE: DR. MICHAEL E SANDLIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	8971	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	731152977001	OTHER	OK	BCBS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346243102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL E SANDLIN M.D.

Provider Business Mailing Address
First Line	:	1201 S BELMONT AVE
Second Line	:	STE 207
City	:	OKMULGEE
State	:	OK
Zip	:	74447-6351
Country	:	US
Telephone Number	:	918-758-0555
Fax Number	:	918-758-3431

Provider Business Practice Location Address
First Line	:	1201 S BELMONT AVE
Second Line	:	STE 207
City	:	OKMULGEE
State	:	OK
Zip	:	74447-6351
Country	:	US
Telephone Number	:	918-758-0555
Fax Number	:	918-758-3431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/28/2008

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Directions to “ DR. MICHAEL E SANDLIN M.D.” Practice Location

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