| |
3270 S Delaware Pl Suite 300 Tulsa OK 74105-2432 | |
(918) 742-8992 | |
(918) 742-2137 |
Full Name | |
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Speciality | Otolaryngology |
Location | 3270 S Delaware Pl, Tulsa, Oklahoma |
Authorized Official Name and Position | Ronald F Davis (PARTNER SEC TREAS) |
Authorized Official Contact | 5019859944 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2227 West Main Street Jacksonville AR 72076 Ph: (501) 985-9944 | 3270 S Delaware Pl Suite 300 Tulsa OK 74105-2432 Ph: (918) 742-8992 |
NPI Number | 1679643704 |
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Provider Enumeration Date | 11/08/2006 |
Last Update Date | 08/27/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679643704 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207Y00000X | Otolaryngology | (* (Not Available)) | Primary |
208D00000X | General Practice | (* (Not Available)) | Secondary |
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