Healthcare Provider Details

I. General information

NPI: 1780972224
Provider Name (Legal Business Name): TULSA UROLOGY PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W BOISE CIR #210
BROKEN ARROW OK
74012-4906
US

IV. Provider business mailing address

800 W BOISE CIR #210
BROKEN ARROW OK
74012-4906
US

V. Phone/Fax

Practice location:
  • Phone: 918-872-9611
  • Fax: 918-872-9962
Mailing address:
  • Phone: 918-872-9611
  • Fax: 918-872-9962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number17425
License Number StateOK

VIII. Authorized Official

Name: DR. RICHARD B SAINT
Title or Position: OWNER
Credential: MD
Phone: 918-872-9611