Healthcare Provider Details

I. General information

NPI: 1497746903
Provider Name (Legal Business Name): CALVIN PEITREI MONROE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 EAST APACHE STREET NORTH
TULSA OK
74106-3938
US

IV. Provider business mailing address

PO BOX 19639
SPRINGFIELD IL
62794-9639
US

V. Phone/Fax

Practice location:
  • Phone: 918-794-5800
  • Fax: 918-794-7775
Mailing address:
  • Phone: 217-545-8000
  • Fax: 844-470-2486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036.111520
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01095436A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number24674
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: