Provider Demographics
NPI:1447541172
Name:BEAIR-BUTLER, KARA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:MARIE
Last Name:BEAIR-BUTLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:MARIE
Other - Last Name:BEAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:5018 E 68TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3338
Mailing Address - Country:US
Mailing Address - Phone:918-995-2395
Mailing Address - Fax:918-209-4916
Practice Address - Street 1:5018 E 68TH ST STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3338
Practice Address - Country:US
Practice Address - Phone:918-995-2395
Practice Address - Fax:918-209-4916
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5195208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200549680AMedicaid
OK200549680AMedicaid