Provider Demographics
NPI:1790940500
Name:BADER, ELIZABETH TRIGALET (DO)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:TRIGALET
Last Name:BADER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12150 E 96TH ST N STE 101
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5339
Mailing Address - Country:US
Mailing Address - Phone:918-716-5437
Mailing Address - Fax:539-202-5020
Practice Address - Street 1:12150 E 96TH ST N STE 101
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5339
Practice Address - Country:US
Practice Address - Phone:918-716-5437
Practice Address - Fax:539-202-5020
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4738208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics