Healthcare Provider Details

I. General information

NPI: 1316914542
Provider Name (Legal Business Name): SCOTT J DUNITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 S 109TH E AVE
TULSA OK
74146
US

IV. Provider business mailing address

4802 S 109TH E AVE
TULSA OK
74146
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-1400
  • Fax: 918-392-1488
Mailing address:
  • Phone: 918-392-1400
  • Fax: 918-392-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number16459
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: