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NPI Code Detail

MEDICARE: KATIE METTLER DO

MEDICARE: KATIE METTLER DO
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
1208600000XSurgery Physician7017OK

General Provider Information

NPI Number : 1811457740
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE METTLER DO
Provider Business Mailing Address
First Line : 5310 E 31ST ST STE 13
Second Line :
City : TULSA
State : OK
Zip : 74135-5013
Country : US
Telephone Number : 918-561-5701
Fax Number : 918-561-1173
Provider Business Practice Location Address
First Line : 802 S JACKSON AVE STE 505
Second Line :
City : TULSA
State : OK
Zip : 74127-9060
Country : US
Telephone Number : 918-747-5322
Fax Number : 918-746-7604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2019
Last Update Date : 07/02/2024

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Directions to “ KATIE METTLER DO” Practice Location

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