Provider Demographics
NPI:1518453109
Name:GIBSON-SANCHEZ, MACY ANN (DO)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:ANN
Last Name:GIBSON-SANCHEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MACY
Other - Middle Name:ANN
Other - Last Name:GIBSON-SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1120 S UTICA AVE STE G100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4012
Mailing Address - Country:US
Mailing Address - Phone:918-392-0175
Mailing Address - Fax:
Practice Address - Street 1:1120 S UTICA AVE STE G100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4012
Practice Address - Country:US
Practice Address - Phone:918-392-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8478207V00000X
MI5101024366207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology