Healthcare Provider Details

I. General information

NPI: 1629305149
Provider Name (Legal Business Name): GREATER TULSA FOOT & ANKLE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 E. 31ST STREET SUITE 2, GREATER TULSA FOOT & ANKLE CENTER, PLLC
TULSA OK
74135
US

IV. Provider business mailing address

3540 E. 31ST STREET SUITE 2, GREATER TULSA FOOT & ANKLE CENTER, PLLC
TULSA OK
74135
US

V. Phone/Fax

Practice location:
  • Phone: 918-747-8997
  • Fax: 918-744-8011
Mailing address:
  • Phone: 918-747-8997
  • Fax: 918-744-8011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFF FINKENSTAEDT
Title or Position: OWNER
Credential: DPM
Phone: 918-747-8997