| State Of Oklahoma Osu Center For Health Sciences | |
|
6333 E Skelly Dr Tulsa OK 74135-6106 | |
| (918) 561-1700 | |
| (918) 561-1701 |
| Full Name | State Of Oklahoma Osu Center For Health Sciences |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 6333 E Skelly Dr, Tulsa, Oklahoma |
| Authorized Official Name and Position | Eric John Polak (VP/CFO) |
| Authorized Official Contact | 9185618422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Oklahoma Osu Center For Health Sciences 2401 Southwest Blvd Tulsa OK 74107-2726 Ph: (918) 561-1700 | State Of Oklahoma Osu Center For Health Sciences 6333 E Skelly Dr Tulsa OK 74135-6106 Ph: (918) 561-1700 |
| NPI Number | 1588229033 |
|---|---|
| Provider Enumeration Date | 05/09/2019 |
| Last Update Date | 05/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588229033 | NPI | - | NPPES |
| 100757080A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
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