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NPI Code Detail

MEDICARE: DR. JUDITH WOLFSTEIN M.D.

MEDICARE: DR. JUDITH WOLFSTEIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD062019LPA
22085R0202XDiagnostic Radiology Physician76607MN
32085R0202XDiagnostic Radiology Physician26271OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013914456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDITH WOLFSTEIN M.D.
Provider Business Mailing Address
First Line : 4500 S GARNETT RD
Second Line : STE 300
City : TULSA
State : OK
Zip : 74146-5238
Country : US
Telephone Number : 918-728-6194
Fax Number : 855-917-2040
Provider Business Practice Location Address
First Line : 744 W 9TH ST
Second Line :
City : TULSA
State : OK
Zip : 74127-9020
Country : US
Telephone Number : 918-728-6194
Fax Number : 918-664-2521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 04/14/2025

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Directions to “ DR. JUDITH WOLFSTEIN M.D.” Practice Location

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