Healthcare Provider Details

I. General information

NPI: 1649631367
Provider Name (Legal Business Name): RITTER PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10507 E 91ST ST STE. 150
TULSA OK
74133-5589
US

IV. Provider business mailing address

1312 S CYPRESS LN
BROKEN ARROW OK
74012-6119
US

V. Phone/Fax

Practice location:
  • Phone: 918-806-8800
  • Fax: 918-286-7002
Mailing address:
  • Phone: 918-806-8800
  • Fax: 918-286-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateOK

VIII. Authorized Official

Name: DR. VALERIE NOEL RITTER
Title or Position: PHYSICIAN/OWNER
Credential: D.O.
Phone: 918-806-8800