Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mission Street Medical Clinic Inc

Organization Family Medicine Physician · NPI 1972600112

Mission Street Medical Clinic Inc provides Family Medicine Physician services 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 Not confirmed with CMS for 15 years — call before visiting
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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