Bethea, Samuel Isaac

Bethea, Samuel Isaac is an sole proprietor health care provider with primary practice located at 1071 W Blue Starr Dr Ste 105 , Claremore OK 74017-2869. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bethea, Samuel Isaac can be contacted via phone (918) 361-0600.

Contact Information

Primary practice address
1071 W Blue Starr Dr Ste 105 Claremore OK 74017-2869
Phone: (918) 361-0600
Fax: (918) 927-3201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2431 Oklahoma

Profile Details

NPI number 1992193676
LBN Legal business name Bethea, Samuel Isaac
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2015
Last updated Feb 23rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992193676 NPPES
Oklahoma MEDICAID 200570050A

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