Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | P3785 | TX |
N | 111NI0900X | Internist | P3785 | TX |
Y | 207RC0000X | Internist - Cardiovascular Disease | 31810 | OK |
NPI | 1013147248 |
---|---|
Provider Name | Saran Desiree Oliver |
First Address | Tulsa, OK 74133-5718 |
Second Address | Pryor, OK 74361-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2009 |
Last Update Date | 16/09/2016 |