Healthcare Provider Details

I. General information

NPI: 1437124005
Provider Name (Legal Business Name): JANET C MATTHEWS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET C CAMPBELL

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WOODWARD BLVD
TULSA OK
74114-1134
US

IV. Provider business mailing address

111 WOODWARD BLVD
TULSA OK
74114-1134
US

V. Phone/Fax

Practice location:
  • Phone: 918-605-3758
  • Fax: 918-592-6410
Mailing address:
  • Phone: 918-605-3758
  • Fax: 918-592-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3867
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: