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4415 S Harvard Ave Ste 209 Tulsa OK 74135-2618 | |
(202) 256-4116 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 4415 S Harvard Ave Ste 209, Tulsa, Oklahoma |
Authorized Official Name and Position | Mike Kapsa (CFO) |
Authorized Official Contact | 5392021585 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1025 Connecticut Ave Nw Ste 907 Washington DC 20036-5434 Ph: (202) 256-4116 | 4415 S Harvard Ave Ste 209 Tulsa OK 74135-2618 Ph: (202) 256-4116 |
NPI Number | 1477044790 |
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Provider Enumeration Date | 05/22/2018 |
Last Update Date | 05/14/2020 |
Identifier | Type | State | Issuer |
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1477044790 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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