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NPI Code Detail

MEDICARE: OSTEOPATHIC PHYSICIANS OF TULSA, INC.

MEDICARE: OSTEOPATHIC PHYSICIANS OF TULSA, 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
1207RN0300XNephrology Physician3780OK

Other Identifiers

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

General Provider Information

NPI Number : 1487735593
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSTEOPATHIC PHYSICIANS OF TULSA, INC.
Provider Business Mailing Address
First Line : 6465 S YALE AVE
Second Line : STE 401
City : TULSA
State : OK
Zip : 74136-7823
Country : US
Telephone Number : 918-582-3154
Fax Number : 918-582-3593
Provider Business Practice Location Address
First Line : 6465 S YALE AVE STE 401
Second Line :
City : TULSA
State : OK
Zip : 74136-7806
Country : US
Telephone Number : 918-582-3154
Fax Number : 918-582-3593
Authorized Official
Title or Position : PRACTICE MANAGER
Name : TANA CEDERSTROM
Credential :
Telephone Number : 918-748-3383
Provider Enumeration Date : 10/17/2006
Last Update Date : 02/13/2025

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Directions to “OSTEOPATHIC PHYSICIANS OF TULSA, INC. ” 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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