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1255334496

NPI Code Detail

MEDICARE: DR. BARRY CLINTON MIRTSCHING MD

MEDICARE: DR. BARRY CLINTON MIRTSCHING MD

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	207RX0202X	Medical Oncology Physician	H4558	TX
2	207RH0003X	Hematology & Oncology Physician	H4558	TX
3	208M00000X	Hospitalist Physician	31184	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1255334496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY CLINTON MIRTSCHING MD

Provider Business Mailing Address
First Line	:	6600 S YALE AVE
Second Line	:	SUITE 1400
City	:	TULSA
State	:	OK
Zip	:	74136-3347
Country	:	US
Telephone Number	:	918-488-6001
Fax Number	:	918-488-6010

Provider Business Practice Location Address
First Line	:	6161 S YALE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-1902
Country	:	US
Telephone Number	:	918-502-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/31/2015

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Directions to “ DR. BARRY CLINTON MIRTSCHING MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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