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General NPI Number Information
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NPI Number | 1871032094
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TULSA ALEXANDER HEALTH CENTER
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 800 S TUCKER DR
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City | TULSA
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State | OK
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Zip | 74104-9700
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Country | US
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Telephone | 918-631-2241
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Fax |
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Provider Business Mailing Address
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Address Line | 800 S TUCKER DR
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City | TULSA
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State | OK
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Zip | 74104-9700
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Country | US
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Telephone | 918-631-2241
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KARA MARIE BEAIR BUTLER
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Credential | DO
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Telephone | 918-631-2241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5195
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2767
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5195
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License Number State | OK
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