Healthcare Provider Details

I. General information

NPI: 1053708701
Provider Name (Legal Business Name): HILARY REDEMANN D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HILARY C PARKER

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 E 41ST ST
TULSA OK
74135-2527
US

IV. Provider business mailing address

2152 S FLORENCE PL
TULSA OK
74114-1839
US

V. Phone/Fax

Practice location:
  • Phone: 918-619-4400
  • Fax: 918-660-3132
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number6043
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: