Healthcare Provider Details

I. General information

NPI: 1770874232
Provider Name (Legal Business Name): GREENWOOD HEALTHCARE SPECIALISTS FOR WOMEN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 E APACHE ST
TULSA OK
74106-3938
US

IV. Provider business mailing address

1216 EAST APACHE STREET NORTH
TULSA OK
74106-3938
US

V. Phone/Fax

Practice location:
  • Phone: 918-794-5800
  • Fax: 918-794-7775
Mailing address:
  • Phone: 918-794-5800
  • Fax: 918-794-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number24674
License Number StateOK

VIII. Authorized Official

Name: MRS. TAJAUNIA T. MONROE
Title or Position: OFFICE MANAGER
Credential:
Phone: 918-794-5800