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General NPI Number Information
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NPI Number | 1518779107
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Entity Type | Organization
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Legal Business Name | UROLOGIC SPECIALISTS OF OKLAHOMA INC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 3400 E FRANK PHILLIPS BLVD STE 700
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City | BARTLESVILLE
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State | OK
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Zip | 74006-2495
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Country | US
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Telephone | 918-248-0995
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Fax | 918-248-0921
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Provider Business Mailing Address
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Address Line | 10901 E 48TH ST
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City | TULSA
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State | OK
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Zip | 74146-5830
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Country | US
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Telephone | 918-749-8765
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Fax | 918-392-2155
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAUN GOBIND SINGH GREWAL
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Credential | MD
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Telephone | 918-749-8765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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