Healthcare Provider Details

I. General information

NPI: 1891711057
Provider Name (Legal Business Name): HEARING SPECIALISTS OF TULSA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 S UTICA AVE SUITE 302
TULSA OK
74104-4000
US

IV. Provider business mailing address

1145 S UTICA AVE SUITE 302
TULSA OK
74104-4000
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-3737
  • Fax: 918-592-3337
Mailing address:
  • Phone: 918-592-3737
  • Fax: 918-592-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number70
License Number StateOK

VIII. Authorized Official

Name: MS. JULIA A SHIRK
Title or Position: PRESIDENT
Credential: MA
Phone: 918-592-3737