Provider Demographics
NPI:1457508525
Name:COFFEY, SARA MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MARIE
Last Name:COFFEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:5310 E 31ST ST FL 13
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5018
Mailing Address - Country:US
Mailing Address - Phone:918-561-5701
Mailing Address - Fax:918-561-1173
Practice Address - Street 1:5310 E 31ST ST FL LL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5018
Practice Address - Country:US
Practice Address - Phone:918-236-4000
Practice Address - Fax:918-236-4001
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK55422084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371211YLFBOtherMEDICARE
OK200547630AMedicaid