Healthcare Provider Details

I. General information

NPI: 1932015823
Provider Name (Legal Business Name): OSIMM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8141 E. 74TH PLACE
TULSA OK
74133-2925
US

IV. Provider business mailing address

8141 E. 74TH PLACE
TULSA OK
74133-2925
US

V. Phone/Fax

Practice location:
  • Phone: 918-884-7800
  • Fax: 539-777-2523
Mailing address:
  • Phone: 918-884-7800
  • Fax: 539-777-2523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LON DUSING
Title or Position: COO
Credential:
Phone: 952-215-4151