Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mission Street Medical Clinic Inc

Organization Family Medicine Physician · NPI 1972600112

Mission Street Medical Clinic Inc is a Family Medicine Physician in Sapulpa, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2006.

Licensed in
OK
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

615 S Mission St Ste A
Sapulpa, OK 74066-4635
Phone: (918) 224-9555
Fax: (918) 224-8001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2405 (OK)

Record details

NPI number1972600112
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dianna Willis — Doctor · (918) 224-9555
NPI enumeratedSeptember 20, 2006
Last updated in NPPESDecember 30, 2010
Mailing address615 S Mission St Ste A, Sapulpa, OK 74066-4635

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