Provider Demographics
NPI:1417390675
Name:SAGER, ELIZABETH JANE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:SAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JANE
Other - Last Name:TURMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1908 RUIDOSA DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6846
Mailing Address - Country:US
Mailing Address - Phone:405-306-2826
Mailing Address - Fax:
Practice Address - Street 1:1908 RUIDOSA DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6846
Practice Address - Country:US
Practice Address - Phone:405-306-2826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ86252080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program