Provider Demographics
NPI:1720390990
Name:SIBLEY, TIFFANY WEMHANER (DO)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:WEMHANER
Last Name:SIBLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:WEMHANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8210
Practice Address - Street 1:102 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-6509
Practice Address - Country:US
Practice Address - Phone:918-246-5750
Practice Address - Fax:918-246-5714
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60351441207P00000X
OK4957207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA356939OtherSTATE L&I
WAG8950412Medicare PIN
WA356939OtherSTATE L&I