Healthcare Provider Details

I. General information

NPI: 1912968652
Provider Name (Legal Business Name): MICHAEL WARREN GRIFFIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 E 81ST ST SUITE 1100
TULSA OK
74137-4250
US

IV. Provider business mailing address

2448 E 81ST ST SUITE 1100
TULSA OK
74137-4250
US

V. Phone/Fax

Practice location:
  • Phone: 918-505-3400
  • Fax: 918-508-7070
Mailing address:
  • Phone: 918-505-3400
  • Fax: 918-508-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number3662
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: