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NPI Code Detail

MEDICARE: CASS CHERRY D.O.

MEDICARE: CASS CHERRY D.O.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician5725OK
3207P00000XEmergency Medicine Physician05-38741KS
4207P00000XEmergency Medicine Physician2016016167MO

General Provider Information

NPI Number : 1538587316
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASS CHERRY D.O.
Provider Business Mailing Address
First Line : 1717 S UTICA AVE
Second Line : STE A
City : TULSA
State : OK
Zip : 74104-5346
Country : US
Telephone Number : 918-599-5373
Fax Number :
Provider Business Practice Location Address
First Line : 744 W 9TH ST
Second Line : OSU MEDICAL CENTER GRADUATE MEDICAL EDUCATION
City : TULSA
State : OK
Zip : 74127-9020
Country : US
Telephone Number : 918-599-5923
Fax Number : 918-599-5949
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2014
Last Update Date : 07/10/2018

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Directions to “ CASS CHERRY D.O.” Practice Location

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