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General NPI Number Information
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NPI Number | 1790407419
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Entity Type | Organization
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Legal Business Name | WARREN CLINIC INC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1866 E 15TH ST
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City | TULSA
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State | OK
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Zip | 74104-4611
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Country | US
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Telephone | 918-884-2884
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Fax | 918-884-2885
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Provider Business Mailing Address
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Address Line | 6600 S YALE AVE STE 1200
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City | TULSA
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State | OK
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Zip | 74136-3361
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Country | US
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Telephone | 918-488-6056
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Fax | 918-488-6098
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Authorized Official
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Title or Position | SR VP, PRESIDENT WARREN CLINIC
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Name | COLLIN HENRY
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Credential | JD
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Telephone | 918-494-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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