Provider Demographics
NPI:1952659732
Name:OKLAHOMA SLEEP SPECIALISTS LLC
Entity Type:Organization
Organization Name:OKLAHOMA SLEEP SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEWNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-743-8200
Mailing Address - Street 1:6966 S UTICA AVE
Mailing Address - Street 2:STE 225
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3903
Mailing Address - Country:US
Mailing Address - Phone:918-492-6333
Mailing Address - Fax:918-493-9405
Practice Address - Street 1:4157 S HARVARD AVE
Practice Address - Street 2:STE 130
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2631
Practice Address - Country:US
Practice Address - Phone:918-492-6333
Practice Address - Fax:918-493-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22222207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Single Specialty