Healthcare Provider Details

I. General information

NPI: 1891282877
Provider Name (Legal Business Name): PREMIER RHEUMATOLOGY OF OKLAHOMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6114 E. 61ST STREET
TULSA OK
74136
US

IV. Provider business mailing address

6114 E. 61ST STREET
TULSA OK
74136
US

V. Phone/Fax

Practice location:
  • Phone: 918-488-8840
  • Fax: 918-488-8842
Mailing address:
  • Phone: 918-488-8840
  • Fax: 918-488-8842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE GLADD FOLEY
Title or Position: DO/OWNER
Credential: D.O.
Phone: 918-488-8840