Healthcare Provider Details

I. General information

NPI: 1609722016
Provider Name (Legal Business Name): DACK EUGENE ZERGER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10202 S QUEBEC AVE
TULSA OK
74137-5905
US

IV. Provider business mailing address

10202 S QUEBEC AVE
TULSA OK
74137-5905
US

V. Phone/Fax

Practice location:
  • Phone: 918-978-0278
  • Fax:
Mailing address:
  • Phone: 918-978-0278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number203805
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: