MEDICARE: OKLAHOMA SPINE AND BRAIN INSTITUTE

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	174400000X	Specialist	15858	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CS2244	OTHER	OK	RAILROAD MEDICARE

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	:	1588625339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA SPINE AND BRAIN INSTITUTE

Provider Business Mailing Address
First Line	:	6802 S OLYMPIA AVE
Second Line	:	STE300
City	:	TULSA
State	:	OK
Zip	:	74132-1823
Country	:	US
Telephone Number	:	918-749-0762
Fax Number	:	918-744-4246

Provider Business Practice Location Address
First Line	:	6802 S OLYMPIA AVE
Second Line	:	STE300
City	:	TULSA
State	:	OK
Zip	:	74132-1823
Country	:	US
Telephone Number	:	918-749-0762
Fax Number	:	918-744-4246

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. DANIEL M HARWELL
Credential	:	MD
Telephone Number	:	918-749-0762

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/03/2025

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Directions to “OKLAHOMA SPINE AND BRAIN INSTITUTE ” Practice Location

Language	Start Address	Practice Location

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