MEDICARE: RESULTS MEDICAL AESTHETICS LLC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1033688270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESULTS MEDICAL AESTHETICS LLC

Provider Business Mailing Address
First Line	:	8014 S. 101ST E. AVE.
Second Line	:	SUITE 200
City	:	TULSA
State	:	OK
Zip	:	74133-4580
Country	:	US
Telephone Number	:	918-994-9170
Fax Number	:	918-872-6505

Provider Business Practice Location Address
First Line	:	8014 S. 101ST E. AVE.
Second Line	:	SUITE 200
City	:	TULSA
State	:	OK
Zip	:	74133-4580
Country	:	US
Telephone Number	:	918-994-9170
Fax Number	:	918-872-6505

Authorized Official
Title or Position	:	MD/AUTHORIZED OFFICIAL
Name	:	LAURA BILBRUCK
Credential	:	MD
Telephone Number	:	918-994-9170

Provider Enumeration Date	:	11/16/2018
Last Update Date	:	11/16/2018

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