=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821036823
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURTIS V. WOLF, II, M.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2006
-----------------------------------------------------
Last Update Date | 12/13/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1145 S UTICA AVE SUITE 362
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74104-4000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-592-3937
-----------------------------------------------------
Fax | 918-592-3935
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1145 S UTICA AVE SUITE 362
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74104-4000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-592-3937
-----------------------------------------------------
Fax | 918-592-3935
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | DAWNA BARTLING
-----------------------------------------------------
Credential | NCLCE
-----------------------------------------------------
Telephone | 918-592-3937
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------