Healthcare Provider Details

I. General information

NPI: 1659734283
Provider Name (Legal Business Name): SETH MIGDALSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8921 S MINGO RD
TULSA OK
74133-5841
US

IV. Provider business mailing address

8921 S MINGO RD
TULSA OK
74133-5841
US

V. Phone/Fax

Practice location:
  • Phone: 918-002-9162
  • Fax:
Mailing address:
  • Phone: 888-397-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number11778298-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number32204
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: