Individual provider · Type 1 NPI

Samuel Spencer Jellison, DO

Student in an Organized Health Care Education/Training Program · Tulsa, OK

NPI number 1891371373 Active

Practice location

717 S Houston Ave Fl 3
Tulsa, OK 74127-9023

Call (918) 382-3535 Map

Fax (918) 382-3559

Mailing address

169 Ashley Avenue, Room 202 Main Hospital, MSC333
Charleston, SC 29425

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Neuroradiology Physician 2085N0700X7750 (OK)
Diagnostic Radiology Physician 2085R0202X7750 (OK)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2 other providers at this address

Other student in an organized health care education/training program providers in Tulsa

See all in Tulsa →

About NPI 1891371373

Samuel Spencer Jellison, DO's National Provider Identifier is 1891371373, issued on Mar 23, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tulsa, OK. The record was last updated on May 22, 2026.