# OKLAHOMA STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OSU Physicians South Tulsa OBGYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316437494
- **Authorized official:** ERIC JOHN POLAK (VP)
- **Authorized official phone:** (918) 561-8422

## Contact information

- **Practice address:** 6126 E 61ST ST, TULSA, OK 74136-2117
- **Practice address phone:** (918) 294-3430
- **Practice address fax:** (918) 294-3910
- **Mailing address:** 5310 E 31ST ST STE 13, TULSA, OK 74135-5013
- **Mailing address phone:** (918) 561-5701
- **Mailing address fax:** (918) 561-1173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 05/15/2018
- **Last updated:** 10/28/2024