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General NPI Number Information
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NPI Number | 1154385730
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Entity Type | Organization
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Legal Business Name | BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 4502 E 41ST ST
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City | TULSA
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State | OK
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Zip | 74135-2553
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Country | US
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Telephone | 918-660-3632
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Fax | 918-660-3631
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Provider Business Mailing Address
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Address Line | 4502 E 41ST ST 2G08 OU PHYSICIANS TULSA CLINICAL SERVICES
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City | TULSA
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State | OK
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Zip | 74135-2553
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Country | US
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Telephone | 918-660-3632
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Fax | 918-660-3631
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | JONATHAN E JOINER
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Credential | CPA, MBA
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Telephone | 918-660-3081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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