Provider Demographics
NPI:1184797813
Name:SARAH VON MULLER, MD, PLLC
Entity type:Organization
Organization Name:SARAH VON MULLER, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:VON MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-294-3332
Mailing Address - Street 1:1615 S EUCALYPTUS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-5990
Mailing Address - Country:US
Mailing Address - Phone:918-294-3332
Mailing Address - Fax:918-294-3003
Practice Address - Street 1:1615 S EUCALYPTUS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5990
Practice Address - Country:US
Practice Address - Phone:918-294-3332
Practice Address - Fax:918-294-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18754207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2993894OtherAETNA PROVIDER NUMBER
OKP00030111OtherRAILROAD MEDICARE
OKF84795Medicare UPIN