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General NPI Number Information
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NPI Number | 1497793095
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Entity Type | Organization
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Legal Business Name | OKLAHOMA GASTROENTEROLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1145 S UTICA AVE SUITE 701
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City | TULSA
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State | OK
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Zip | 74104-4000
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Country | US
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Telephone | 918-582-6544
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Fax | 918-582-6549
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Provider Business Mailing Address
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Address Line | 1145 S UTICA AVE SUITE 701
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City | TULSA
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State | OK
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Zip | 74104-4000
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Country | US
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Telephone | 918-582-6544
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Fax | 918-582-6549
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DEBBIE LANGLEY
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Credential |
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Telephone | 918-582-6544
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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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