Healthcare Provider Details

I. General information

NPI: 1366562589
Provider Name (Legal Business Name): PLASTIC SURGERY ASSOCIATES OF TULSA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 S YALE AVE SUITE 1020
TULSA OK
74136-8384
US

IV. Provider business mailing address

6585 S YALE AVE SUITE 1020
TULSA OK
74136-8384
US

V. Phone/Fax

Practice location:
  • Phone: 918-481-2900
  • Fax: 918-481-2985
Mailing address:
  • Phone: 918-481-2900
  • Fax: 918-481-2985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PALMER R RAMEY JR.
Title or Position: PARTNER
Credential: M.D.
Phone: 918-481-2900