| Warren Clinic South Family Medicine Soonercare Group | |
|
6600 S Yale Ave Ste 1400 Tulsa OK 74136-3310 | |
| (918) 488-6001 | |
| Not Available |
| Full Name | Warren Clinic South Family Medicine Soonercare Group |
|---|---|
| Speciality | Family Medicine |
| Location | 6600 S Yale Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Cathey Rae Duplissey (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9184886687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Clinic South Family Medicine Soonercare Group 10505 E 91st St Suite 110 Tulsa OK 74133-5801 Ph: () - | Warren Clinic South Family Medicine Soonercare Group 6600 S Yale Ave Ste 1400 Tulsa OK 74136-3310 Ph: (918) 488-6001 |
| NPI Number | 1861650251 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 11/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861650251 | NPI | - | NPPES |
| 100739490E | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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