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General NPI Number Information
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NPI Number | 1316935463
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Entity Type | Individual
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Provider Name | DIXIE L GRANT-COLLINS DO
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 744 W 9TH ST
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City | TULSA
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State | OK
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Zip | 74127-9020
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Country | US
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Telephone | 918-587-2561
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT. 672
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City | TULSA
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State | OK
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Zip | 74182-0001
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Country | US
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Telephone | 866-321-8433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 2524
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License Number State | OK
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