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General NPI Number Information
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NPI Number | 1467836692
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Entity Type | Organization
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Legal Business Name | AHS OKLAHOMA PHYSICIAN GROUP, LLC
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 9245 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74133-5793
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Country | US
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Telephone | 918-574-0250
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Fax | 918-574-0259
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Provider Business Mailing Address
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Address Line | 9245 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74133-5793
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Country | US
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Telephone | 918-574-0250
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Fax | 918-574-0259
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JAMES E KALTENBACHER
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Credential | MBA, CMPE
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Telephone | 918-579-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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