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Organization
OKLAHOMA STATE UNIVERSITY
Active
Organization
OKLAHOMA STATE UNIVERSITY
Active
Other names
OSU Physicians Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JOHN POLAK (VP)
(918) 561-8422
Entity
Organization
Contact information
Practice address
717 S HOUSTON STE 300, TULSA, OK 74127-9006
(918) 382-5064
(918) 382-3589
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100757080A
—
OK
Enumeration date
12/13/2006
Last updated
02/18/2026
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