Provider Demographics
NPI:1437359288
Name:GRIFFIN, CHELSEY DIANE (DO)
Entity Type:Individual
Prefix:DR
First Name:CHELSEY
Middle Name:DIANE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4415 S HARVARD AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-9700
Mailing Address - Country:US
Mailing Address - Phone:918-392-3444
Mailing Address - Fax:918-392-3472
Practice Address - Street 1:4415 S HARVARD AVE STE 125
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-9700
Practice Address - Country:US
Practice Address - Phone:918-392-3444
Practice Address - Fax:918-392-3472
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200204880AMedicaid
OK200204880BMedicaid