LEA SARAH HUMPHREY


Address: 1203 E Ross Byp, Tahlequah, OK 74464-4133
Phone: 9184531234

LEA SARAH HUMPHREY (NPI# 1649584855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649584855
Entity Type Individual
Full Name LEA SARAH HUMPHREY
Credential D.O.
Practice Address 1203 E Ross Byp
Tahlequah
OK 74464-4133
Mailing Address 100 Mercy Way
Ste 560
Joplin
MO 64804-4524
Practice Telephone 9184531234
Practice Fax Number 9184539107
Mailing Telephone 4175568555
Mailing Fax Number 4175568553
Enumeration Date 2010-07-29
Last Update Date 2019-10-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207YX0905X Otolaryngology
Specialization: Otolaryngology/Facial Plastic Surgery
6819 OK Allopathic & Osteopathic Physicians
N 207YX0905X Otolaryngology
Specialization: Otolaryngology/Facial Plastic Surgery
2010019023 MO Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OK 200593430A 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
100 Mercy Way, Ste 560, Joplin, MO 648044524 4175568555 4175568553

Office Location

Street Address 1203 E ROSS BYP
City TAHLEQUAH
State OK
Zip Code 74464-4133

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700875598 Lori Lyn Enlow Nurse Practitioner 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 2005-10-14
1073164125 Northeastern Oklahoma Community Health Centers, Inc. Clinic/Center 1203 E Ross Byp, Tahlequah, OK 74464-4133 2019-09-20
1023311438 Osu Center for Health Sciences Clinic/Center 1203 E Ross Byp, Suite 1a, Tahlequah, OK 74464-4133 2010-12-08
1316258619 Osu Center for Health Sciences Clinic/Center 1203 E Ross Byp, Tahlequah, OK 74464-4133 2010-07-01
1659568301 Cmg Family Clinic LLC Family Medicine 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 2007-09-26
1720274699 Tracey W. Childers, D.o. P.C. Otolaryngology 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 2007-09-24
1730227299 Philip Dean Watson Physician Assistant 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 2007-02-04
1568412310 Susan K Anderson Otolaryngology 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 2006-05-11
1053371021 Tracey Way Childers Otolaryngology 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 2006-03-24
1114909843 Andrea D Mitchell Physician Assistant 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 2005-11-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184253403 Kendall Harris Student in an Organized Health Care Education/Training Program 100 Bliss Ave, Tahlequah, OK 74464 2020-04-07
1528609302 Norma Brightly Technician 103 Sequoyah, Tahlequah, OK 74464 2019-10-03
1073175832 Jody Lynn Dallis Case Manager/Care Coordinator Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 2019-07-02
1184287849 Perry Jake Proctor Student in an Organized Health Care Education/Training Program 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 2019-04-18
1336657279 Sidney Sheyenne Kimble Case Manager/Care Coordinator 1429 Jack Brown Lane, Tahlequah, OK 74464 2018-01-12
1891225686 Nichols Bradley Alberty Orthotist 1294 East Downing, Suite 3, Tahlequah, OK 74464 2017-06-14
1922549690 Krystal Easter Ms, Lpc Counselor 2201 Oakridge Dr, Tahlequah, OK 74464 2017-03-15
1144777319 Northeastern Oklahoma Community Health Centers, Inc. Clinic/Center 529 N. Oak St., Tahlequah, OK 74464 2016-09-06
1548713456 Clement Isioma Nwadozi Optometrist 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 2016-07-27
1033532635 Wesley Gragg Specialist/Technologist 603 North Grand Avenue, Tahlequah, OK 74464 2014-02-03
Find all providers in zip 74464

Taxonomy Information

Taxonomy Code 207YX0905X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology
Specialization Otolaryngology/Facial Plastic Surgery

Taxonomy Definition

An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053371021 Tracey Way Childers Otolaryngology 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 2006-03-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1538674783 Timothy Jones Md Pllc Otolaryngology 13150 N Macarthur Blvd, Oklahoma City, OK 73142-3017 2017-12-11
1023493566 Chase K Nelson Otolaryngology 744 W 9th St, Tulsa, OK 74127-9020 2015-07-27
1396123246 Caleb Eugene Burrows Otolaryngology 2000 S Wheeling Ave, Ste 900, Tulsa, OK 74104-5647 2015-05-12
1275822926 Bryan Terry Smedley Otolaryngology 10512 N 110th East Ave, Suite 210, Owasso, OK 74055-6636 2011-04-04
1770885931 Ent Associates Pllc Otolaryngology 1201 S Douglas Blvd, Ste L, Midwest City, OK 73130-5239 2010-11-21
1831352723 Jean-maria Christina Langley Otolaryngology 9001 S 101st East Ave, Suite 280, Tulsa, OK 74133-5708 2008-07-09
1427003854 Troy E Major IIi Otolaryngology 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070 2006-05-24
1528021912 Paul David Hunter Otolaryngology 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070 2006-04-08

Competitor

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City TAHLEQUAH
Zip Code 74464

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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