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NPI Code Detail

MEDICARE: BAILEY MITCHELL TRS

MEDICARE: BAILEY MITCHELL TRS
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
1225800000XRecreation Therapist271OK

General Provider Information

NPI Number : 1508612151
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY MITCHELL TRS
Provider Business Mailing Address
First Line : 1239 S TRENTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-5420
Country : US
Telephone Number : 918-588-8807
Fax Number : 918-588-8822
Provider Business Practice Location Address
First Line : 1239 S TRENTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-5420
Country : US
Telephone Number : 918-588-8807
Fax Number : 918-588-8822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2024
Last Update Date : 05/26/2026

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Directions to “ BAILEY MITCHELL TRS” Practice Location

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