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NPI Code Detail

MEDICARE: DR. JOSEPH ALEXANDER INTRIAGO MD

MEDICARE: DR. JOSEPH ALEXANDER INTRIAGO 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
1207Q00000XFamily Medicine Physician01089779BIN
2208M00000XHospitalist Physician47657OK

General Provider Information

NPI Number : 1629650304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH ALEXANDER INTRIAGO MD
Provider Business Mailing Address
First Line : 6502 S YALE AVE STE 3410
Second Line :
City : TULSA
State : OK
Zip : 74136-8329
Country : US
Telephone Number : 918-499-4855
Fax Number : 918-488-6098
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 : 918-494-6303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2021
Last Update Date : 06/17/2026

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