| Southside Medical | |
|
8222 S. Harvard Ave Tulsa OK 74136-1613 | |
| (918) 493-3838 | |
| Not Available |
| Full Name | Southside Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 8222 S. Harvard Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Christoper Vincent Moses (PHYSICIAN) |
| Authorized Official Contact | 9184933838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Medical 8222 S. Harvard Ave Tulsa OK 74136-1613 Ph: (918) 493-3838 | Southside Medical 8222 S. Harvard Ave Tulsa OK 74136-1613 Ph: (918) 493-3838 |
| NPI Number | 1710139076 |
|---|---|
| Provider Enumeration Date | 10/17/2008 |
| Last Update Date | 11/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710139076 | NPI | - | NPPES |
| 100023050A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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