Healthcare Provider Details

I. General information

NPI: 1043309628
Provider Name (Legal Business Name): CVT SURGERY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6804 S CANTON AVE 110
TULSA OK
74136-3423
US

IV. Provider business mailing address

6804 S CANTON AVE 110
TULSA OK
74136-3423
US

V. Phone/Fax

Practice location:
  • Phone: 918-749-6400
  • Fax: 918-388-3999
Mailing address:
  • Phone: 918-749-6400
  • Fax: 918-388-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES M WHITENECK
Title or Position: PRESIDENT/SURGEON
Credential: M.D.
Phone: 918-749-6400