Provider Demographics
NPI:1619936184
Name:SUTHERS, SARA E (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:SUTHERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 MCAULEY BLVD
Mailing Address - Street 2:SUTE 2200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8339
Mailing Address - Country:US
Mailing Address - Phone:405-749-7023
Mailing Address - Fax:705-749-7025
Practice Address - Street 1:4401 MCAULEY BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120
Practice Address - Country:US
Practice Address - Phone:405-749-7023
Practice Address - Fax:405-749-7025
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21760208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200076250AMedicaid
OK200076250AMedicaid
OK246713002Medicare PIN
OKI65229Medicare UPIN