Provider Demographics
NPI:1295759215
Name:SEBASTIAN, ANTHONY (MD, FRCS, FACS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:SEBASTIAN
Suffix:
Gender:M
Credentials:MD, FRCS, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:405-271-7498
Mailing Address - Fax:405-271-4328
Practice Address - Street 1:940 N.E. 13TH STREET
Practice Address - Street 2:SUITE 3000
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5099
Practice Address - Country:US
Practice Address - Phone:405-271-7498
Practice Address - Fax:405-271-4328
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19327204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100005140AMedicaid
OKOK701107Medicare PIN
OK100005140AMedicaid