Provider Demographics
NPI:1588769780
Name:SADEGHI, M SAID (DO)
Entity type:Individual
Prefix:
First Name:M
Middle Name:SAID
Last Name:SADEGHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4606 E 67TH ST
Mailing Address - Street 2:SUITE 400 BUILDING 7
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-4943
Mailing Address - Country:US
Mailing Address - Phone:918-949-9898
Mailing Address - Fax:918-294-0000
Practice Address - Street 1:4606 E 67TH ST
Practice Address - Street 2:SUITE 400 BUILDING 7
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-4943
Practice Address - Country:US
Practice Address - Phone:918-949-9898
Practice Address - Fax:918-728-8091
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3526207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100735860AMedicaid
OK100119820AMedicaid
OK100735860AMedicaid
OK73-1621571OtherTAX I.D. NUMBER