Provider Demographics
NPI:1760453591
Name:STEELE, SUSAN K (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:STEELE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:802 S JACKSON AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-9059
Mailing Address - Country:US
Mailing Address - Phone:918-584-5364
Mailing Address - Fax:918-584-5394
Practice Address - Street 1:802 S JACKSON AVE STE 420
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9059
Practice Address - Country:US
Practice Address - Phone:918-584-5364
Practice Address - Fax:918-584-5394
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100112220BMedicaid
OKOK402419OtherMEDICARE