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NPI Code Detail

MEDICARE: CTCA PHYSICANS GROUP OF OKLAHOMA, INC

MEDICARE: CTCA PHYSICANS GROUP OF OKLAHOMA, INC
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
1174400000XSpecialist

General Provider Information

NPI Number : 1053309591
Entity Type Code : Organization
Provider Name (Legal Business Name) : CTCA PHYSICANS GROUP OF OKLAHOMA, INC
Provider Business Mailing Address
First Line : 5900 BROKEN SOUND PKWY NW
Second Line :
City : BOCA RATON
State : FL
Zip : 33487-2797
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10109 E 79TH ST
Second Line :
City : TULSA
State : OK
Zip : 74133-4564
Country : US
Telephone Number : 847-746-4358
Fax Number : 847-746-4213
Authorized Official
Title or Position : CHIEF ACCOUNTING OFFICER
Name : NEETU MASUTA
Credential :
Telephone Number : 847-342-6978
Provider Enumeration Date : 10/10/2005
Last Update Date : 07/29/2021

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Directions to “CTCA PHYSICANS GROUP OF OKLAHOMA, INC ” Practice Location

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