Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 13641 | OK |
N | 111NI0900X | Internist | 13641 | OK |
Y | 207RR0500X | Rheumatology | 13641 | OK |
NPI | 1023017878 |
---|---|
Provider Name | Sara Lee Newell |
First Address | Tulsa, OK 74136-3310 |
Second Address | Tulsa, OK 74136-1930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 29/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D35088 | (02) |