| Osu-aj Warren Clinic South Memorial Peds | |
|
10506 S Memorial Dr Tulsa OK 74133-6914 | |
| (918) 561-8306 | |
| (918) 561-5747 |
| Full Name | Osu-aj Warren Clinic South Memorial Peds |
|---|---|
| Speciality | Clinic/center |
| Location | 10506 S Memorial Dr, Tulsa, Oklahoma |
| Authorized Official Name and Position | Eric John Polak (VICE PRESIDENT FOR ADMIN/FINANCE) |
| Authorized Official Contact | 9185618422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Osu-aj Warren Clinic South Memorial Peds 2345 Southwest Blvd Tulsa OK 74107-2705 Ph: (918) 561-8306 | Osu-aj Warren Clinic South Memorial Peds 10506 S Memorial Dr Tulsa OK 74133-6914 Ph: (918) 561-8306 |
| NPI Number | 1619523511 |
|---|---|
| Provider Enumeration Date | 08/15/2019 |
| Last Update Date | 10/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619523511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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