Provider Demographics
NPI:1538522875
Name:SAULS, COURTNEY (DO)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SAULS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S WHEELING AVE
Mailing Address - Street 2:STE 304
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5632
Mailing Address - Country:US
Mailing Address - Phone:918-794-7337
Mailing Address - Fax:918-403-6438
Practice Address - Street 1:717 S HOUSTON AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9023
Practice Address - Country:US
Practice Address - Phone:918-382-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6249208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty