# OKLAHOMA STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OSU Physicians Family Medicine Eastgate
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437480670
- **Authorized official:** ERIC JOHN POLAK (VP)
- **Authorized official phone:** (918) 561-8422

## Contact information

- **Practice address:** 14002 E 21ST ST STE 1130, TULSA, OK 74134-1408
- **Practice address phone:** (918) 439-1200
- **Practice address fax:** (918) 439-1199
- **Mailing address:** 5310 E 31ST ST FL 13, TULSA, OK 74135-5018
- **Mailing address phone:** (918) 561-5701
- **Mailing address fax:** (918) 585-9273

## Taxonomy

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

## Other

- **Enumeration date:** 01/28/2010
- **Last updated:** 02/18/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1306882261 | OSU GROUP NPI | — |