Provider Demographics
NPI:1386601318
Name:SARKISIAN, STEVEN R JR (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:SARKISIAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 N PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2023
Mailing Address - Country:US
Mailing Address - Phone:405-943-4413
Mailing Address - Fax:405-942-0115
Practice Address - Street 1:5600 N PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2023
Practice Address - Country:US
Practice Address - Phone:405-943-4413
Practice Address - Fax:405-942-0115
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25180207W00000X, 207WX0009X
TN37549207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200089440AMedicaid
P00329726Medicare PIN
H83302Medicare UPIN
OK200089440AMedicaid