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Organization
OKLAHOMA STATE UNIVERSITY
Active
Organization
OKLAHOMA STATE UNIVERSITY
Active
Other names
OSU Physicians Family Medicine Eastgate
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JOHN POLAK (VP)
(918) 561-8422
Entity
Organization
Contact information
Practice address
14002 E 21ST ST STE 1130, TULSA, OK 74134-1408
(918) 439-1200
(918) 439-1199
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 585-9273
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306882261
OSU GROUP NPI
—
Enumeration date
01/28/2010
Last updated
02/18/2026
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