MEDICARE: DR. PAUL PISARIK 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	207Q00000X	Family Medicine Physician	24771	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

General Provider Information

NPI Number	:	1306843248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL PISARIK MD

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	615-314-8069
Fax Number	:

Provider Business Practice Location Address
First Line	:	3138 S GARNETT RD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-1933
Country	:	US
Telephone Number	:	918-203-7005
Fax Number	:

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/19/2023

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