Basic Information
Provider Information
NPI: 1801071378
EntityType: 2
ReplacementNPI:  
OrganizationName: OLAY PHYSICIANS, PLLC
LastName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 1700 RENAISSANCE BLVD
Address2:  
City: EDMOND
State: OK
PostalCode: 730133022
CountryCode: US
TelephoneNumber: 4058444300
FaxNumber: 4058444333
Practice Location
Address1: 1700 RENAISSANCE BLVD
Address2:  
City: EDMOND
State: OK
PostalCode: 730133022
CountryCode: US
TelephoneNumber: 4058444300
FaxNumber: 4058444333
Other Information
ProviderEnumerationDate: 01/03/2008
LastUpdateDate: 01/03/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: OLAY
AuthorizedOfficialFirstName: SABRINA
AuthorizedOfficialMiddleName: R
AuthorizedOfficialTitleorPosition: MD
AuthorizedOfficialTelephone: 4058444300
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X19464OKN193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 
208000000X19463OKY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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