Provider Demographics
NPI:1821418773
Name:JANSSEN, SARAH (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 E 121ST ST S
Mailing Address - Street 2:STE 200
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2654
Mailing Address - Country:US
Mailing Address - Phone:918-403-7140
Mailing Address - Fax:918-856-5392
Practice Address - Street 1:940 E 36TH ST N
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1953
Practice Address - Country:US
Practice Address - Phone:918-398-9460
Practice Address - Fax:918-992-2822
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK5755207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200606420AMedicaid