Healthcare Provider Details

I. General information

NPI: 1285069708
Provider Name (Legal Business Name): MORTON COMPREHENSIVE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2013
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S HARVARD AVE
TULSA OK
74114-3300
US

IV. Provider business mailing address

1334 N LANSING AVE
TULSA OK
74106-5907
US

V. Phone/Fax

Practice location:
  • Phone: 918-587-2171
  • Fax: 918-295-6194
Mailing address:
  • Phone: 918-587-2171
  • Fax: 918-295-6194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: SAUNYA MOORE
Title or Position: CFO
Credential:
Phone: 918-295-6107