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NPI Code Detail

MEDICARE: KAYLEA CLARK

MEDICARE: KAYLEA CLARK
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
1231H00000XAudiologist

General Provider Information

NPI Number : 1396203907
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEA CLARK
Provider Business Mailing Address
First Line : 11500 N PORTLAND AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-4625
Country : US
Telephone Number : 405-548-4300
Fax Number : 405-548-4350
Provider Business Practice Location Address
First Line : 8125 E 101ST ST STE 50
Second Line :
City : TULSA
State : OK
Zip : 74133-7245
Country : US
Telephone Number : 918-392-7600
Fax Number : 405-548-4350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2019
Last Update Date : 02/28/2025

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Directions to “ KAYLEA CLARK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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