MEDICARE: AHS OKLAHOMA PHYSICIAN GROUP, LLC

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
2	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1649348863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHS OKLAHOMA PHYSICIAN GROUP, LLC

Provider Business Mailing Address
First Line	:	1145 S UTICA AVE
Second Line	:	SUITE 110
City	:	TULSA
State	:	OK
Zip	:	74104-4000
Country	:	US
Telephone Number	:	918-579-3825
Fax Number	:	918-579-1262

Provider Business Practice Location Address
First Line	:	1390 W CHEROKEE ST
Second Line	:
City	:	CLEVELAND
State	:	OK
Zip	:	74020-4044
Country	:	US
Telephone Number	:	918-358-3501
Fax Number	:	918-358-5402

Authorized Official
Title or Position	:	CFO
Name	:	ROBERT LANGLAND
Credential	:
Telephone Number	:	918-579-1000

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	09/11/2025

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