Provider Demographics
NPI:1508524596
Name:SANDAGER, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:SANDAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-6120
Mailing Address - Country:US
Mailing Address - Phone:405-945-6775
Mailing Address - Fax:
Practice Address - Street 1:10628 ADMIRAL CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6801
Practice Address - Country:US
Practice Address - Phone:714-770-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist