| East Tulsa Medical Group | |
|
11445 E 20th St Tulsa OK 74128-6421 | |
| (918) 437-6830 | |
| (918) 437-6171 |
| Full Name | East Tulsa Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 11445 E 20th St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Jeff A Barentine (PARTNER) |
| Authorized Official Contact | 9184376830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Tulsa Medical Group 11445 E 20th St Tulsa OK 74128-6421 Ph: (918) 437-6830 | East Tulsa Medical Group 11445 E 20th St Tulsa OK 74128-6421 Ph: (918) 437-6830 |
| NPI Number | 1114336534 |
|---|---|
| Provider Enumeration Date | 08/11/2014 |
| Last Update Date | 08/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114336534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1567 (Oklahoma) | Primary |
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