Healthcare Provider Details

I. General information

NPI: 1770580110
Provider Name (Legal Business Name): ROBERT LANG KRANZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6839 S CANTON AVE
TULSA OK
74136-3402
US

IV. Provider business mailing address

6839 S CANTON AVE
TULSA OK
74136-3402
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-0612
  • Fax: 918-481-5170
Mailing address:
  • Phone: 918-298-5111
  • Fax: 918-298-9811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number13026
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: