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General NPI Number Information
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NPI Number | 1538356530
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Entity Type | Organization
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Legal Business Name | TULSA FOOT & ANKLE CLINIC, P.C.
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 3315 E 47TH PL STE 102
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City | TULSA
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State | OK
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Zip | 74135-2911
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Country | US
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Telephone | 918-749-4484
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Fax | 918-749-2350
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Provider Business Mailing Address
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Address Line | 3315 E 47TH PL STE 102
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City | TULSA
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State | OK
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Zip | 74135-2911
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Country | US
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Telephone | 918-749-4484
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Fax | 918-749-2350
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT HAYES LEE
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Credential | D.P.M.
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Telephone | 918-749-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 188
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License Number State | OK
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