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General NPI Number Information
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NPI Number | 1255528956
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY OF TULSA INC. DBA CARDIOLOGY DIAGNOSTICS OF TULSA
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 6151 S YALE AVE #400
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City | TULSA
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State | OK
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Zip | 74136-1907
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Country | US
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Telephone | 918-494-8500
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Fax | 918-307-5578
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Provider Business Mailing Address
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Address Line | 6151 S YALE AVE #400
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City | TULSA
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State | OK
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Zip | 74136-1907
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Country | US
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Telephone | 918-494-8500
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Fax | 918-307-5578
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL GENE SPAIN
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Credential | M.D.
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Telephone | 918-494-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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