Healthcare Provider Details

I. General information

NPI: 1164092730
Provider Name (Legal Business Name): MOHAMAD ALRIFAI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 S YALE AVE
TULSA OK
74136-3326
US

IV. Provider business mailing address

1111 W 17TH ST
TULSA OK
74107-1800
US

V. Phone/Fax

Practice location:
  • Phone: 918-481-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8232
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: