Provider Demographics
NPI:1972240570
Name:HULL, SAMANTHA RAE (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:RAE
Last Name:HULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:RAE
Other - Last Name:BROCKLEHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 STANTON L YOUNG BLVD # 2400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5018
Mailing Address - Country:US
Mailing Address - Phone:405-271-8787
Mailing Address - Fax:405-271-8547
Practice Address - Street 1:800 STANTON L YOUNG BLVD # 2400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5018
Practice Address - Country:US
Practice Address - Phone:405-271-8787
Practice Address - Fax:405-271-8547
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39702207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology