MEDICARE: RHONDA LEANN SEDLACEK PA

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	363A00000X	Physician Assistant	15-00830	KS
2	363A00000X	Physician Assistant	2523	OK

General Provider Information

NPI Number	:	1346409695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA LEANN SEDLACEK PA

Provider Business Mailing Address
First Line	:	6600 S YALE AVE
Second Line	:	SUITE 1200
City	:	TULSA
State	:	OK
Zip	:	74136-3347
Country	:	US
Telephone Number	:	918-488-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 S ELM PL STE 225
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-7825
Country	:	US
Telephone Number	:	918-525-1120
Fax Number	:	918-878-8816

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

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	03/27/2026

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