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NPI Code Detail

MEDICARE: QT QUIKMED LLC

MEDICARE: QT QUIKMED LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1013590074
Entity Type Code : Organization
Provider Name (Legal Business Name) : QT QUIKMED LLC
Provider Business Mailing Address
First Line : 4705 S 129TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74134-7005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4705 S 129TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74134-7005
Country : US
Telephone Number : 918-994-3953
Fax Number :
Authorized Official
Title or Position : PROVIDER RELATIONS MANAGER
Name : CAROLYN BARTON
Credential :
Telephone Number : 918-994-3953
Provider Enumeration Date : 04/28/2021
Last Update Date : 08/10/2021

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Directions to “QT QUIKMED LLC ” Practice Location

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