Provider Demographics
NPI:1023302080
Name:SANTILLANO, SARAH MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:SANTILLANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 RIVERSIDE PKWY
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5056
Mailing Address - Country:US
Mailing Address - Phone:918-710-4200
Mailing Address - Fax:918-403-6331
Practice Address - Street 1:7501 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-710-4200
Practice Address - Fax:918-403-6331
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60463893207Q00000X
OK28477207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program