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NPI Code Detail

MEDICARE: DR. MICHAEL E CLOUSER M.D.

MEDICARE: DR. MICHAEL E CLOUSER M.D.
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
12085R0202XDiagnostic Radiology Physician11507OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1300019099OTHEROKRAILROAD MEDICARE
2300129636OTHEROKRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801883400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL E CLOUSER M.D.
Provider Business Mailing Address
First Line : PO BOX 4930
Second Line :
City : TULSA
State : OK
Zip : 74159-0930
Country : US
Telephone Number : 918-747-4975
Fax Number : 918-743-8552
Provider Business Practice Location Address
First Line : 5801 E 41ST ST STE 900
Second Line :
City : TULSA
State : OK
Zip : 74135-5631
Country : US
Telephone Number : 918-747-4975
Fax Number : 918-743-8552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 07/13/2022

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Directions to “ DR. MICHAEL E CLOUSER M.D.” Practice Location

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