Healthcare Provider Details

I. General information

NPI: 1962880062
Provider Name (Legal Business Name): MORTON COMPREHENSIVE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 N LANSING AVE
TULSA OK
74106-5907
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: 918-587-8175
Mailing address:
  • Phone: 918-587-2171
  • Fax: 918-587-8175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN SILVA
Title or Position: CEO
Credential:
Phone: 918-587-2171