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General NPI Number Information
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NPI Number | 1306884812
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Entity Type | Organization
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Legal Business Name | ADULT GASTROENTEROLOGY ASSOCIATES INC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 4200 E SKELLY DR STE 700
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City | TULSA
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State | OK
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Zip | 74135-3256
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Country | US
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Telephone | 918-438-7050
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Fax | 918-221-0835
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Provider Business Mailing Address
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Address Line | PO BOX 305
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City | LOWELL
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State | AR
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Zip | 72745-0305
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Country | US
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Telephone | 918-438-7050
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Fax | 918-221-0835
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DOUGLAS B KLIEWER
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Credential | M.D.
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Telephone | 918-481-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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