Provider Demographics
NPI:1255321162
Name:SAGELY, JOE D (DO)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:D
Last Name:SAGELY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-0218
Mailing Address - Country:US
Mailing Address - Phone:918-789-3146
Mailing Address - Fax:844-560-1455
Practice Address - Street 1:235 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:OK
Practice Address - Zip Code:74016-1833
Practice Address - Country:US
Practice Address - Phone:918-789-3146
Practice Address - Fax:844-560-1455
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2809208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK10071600AMedicaid
OKF08599Medicare UPIN
OK244513218Medicare ID - Type Unspecified
OK100071600BMedicaid