Provider Demographics
NPI:1598034241
Name:JOHN W. SIBLEY, JR., D.C., INC.
Entity Type:Organization
Organization Name:JOHN W. SIBLEY, JR., D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SIBLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:918-749-5741
Mailing Address - Street 1:3322 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3512
Mailing Address - Country:US
Mailing Address - Phone:918-749-5741
Mailing Address - Fax:918-745-9022
Practice Address - Street 1:3322 E 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3512
Practice Address - Country:US
Practice Address - Phone:918-749-5741
Practice Address - Fax:918-745-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT80015Medicare UPIN
OKQDCCQMedicare PIN