# EAR NOSE & THROAT CLINIC OF TULSA, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518028125
- **Authorized official:** C KATHLEEN WORRALL (OFFICE ADMINISTRATION)
- **Authorized official phone:** (918) 744-0228

## Contact information

- **Practice address:** 4444 S HARVARD AVE, \#100, TULSA, OK 74135-2634
- **Practice address phone:** (918) 744-0228
- **Practice address fax:** (918) 744-6613
- **Mailing address:** 4444 S HARVARD AVE, \#100, TULSA, OK 74135-2634
- **Mailing address phone:** (918) 744-0228
- **Mailing address fax:** (918) 744-6613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 08/22/2020