MISSION STREET MEDICAL CLINIC INC – Family Medicine Physician, NPI 1972600112

MISSION STREET MEDICAL CLINIC INC is a healthcare provider. based in Sapulpa, Oklahoma. specializing in Family Medicine Physician. The organization holds a License No. 2405 (OK). The NPI Number for MISSION STREET MEDICAL CLINIC INC is 1972600112

Main info

Organization
Name
MISSION STREET MEDICAL CLINIC INC
NPI
1972600112
Phone
(918) 224-9555
Address
615 S MISSION ST STE A
Authorized Official
DIANNA M WILLIS DOCTOR D.O.
Enumeration Date
20 September 2006
Last Update Date
30 December 2010
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for MISSION STREET MEDICAL CLINIC INC

  • 615 S MISSION ST STE A

    SAPULPA, OK 740664635

    Phone: (918) 224-9555

    Fax: (918) 224-8001

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74066)

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Reviews

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Frequently asked questions

Is there an official ID for MISSION STREET MEDICAL CLINIC INC in U.S. healthcare records?
The official identifier for MISSION STREET MEDICAL CLINIC INC is NPI 1972600112.
Active or inactive — what applies to MISSION STREET MEDICAL CLINIC INC?
You should see MISSION STREET MEDICAL CLINIC INC as active in CMS-hosted NPPES data.
What expertise is attributed to MISSION STREET MEDICAL CLINIC INC?
MISSION STREET MEDICAL CLINIC INC's specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MISSION STREET MEDICAL CLINIC INC?
Travel planning: use Sapulpa, Oklahoma as the reference point for MISSION STREET MEDICAL CLINIC INC, then confirm.
When was this NPI issued?
Enumeration for MISSION STREET MEDICAL CLINIC INC is noted as September 20, 2006 where the registry provides it.

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