Healthcare Provider Details

I. General information

NPI: 1720075112
Provider Name (Legal Business Name): MORTON COMPREHENSIVE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 N LANSING AVE
TULSA OK
74106-5907
US

IV. Provider business mailing address

1334 N LANSING AVE
TULSA OK
74106-5907
US

V. Phone/Fax

Practice location:
  • Phone: 918-295-6137
  • Fax: 918-582-0529
Mailing address:
  • Phone: 918-295-6137
  • Fax: 918-582-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: SAUNYA MOORE
Title or Position: CFO
Credential:
Phone: 918-295-6107