# STATE OF OKLAHOMA OSU CENTER FOR HEALTH SCIENCES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OKLAHOMA STATE UNIVERSITY
- **Other names:** OSU Physicians Addiction Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588229033
- **Legal business name:** OKLAHOMA STATE UNIVERSITY
- **Authorized official:** ERIC JOHN POLAK (VP/CFO)
- **Authorized official phone:** (918) 561-8422

## Contact information

- **Practice address:** 6333 E SKELLY DR, TULSA, OK 74135-6106
- **Practice address phone:** (918) 561-1700
- **Practice address fax:** (918) 561-1701
- **Mailing address:** 2401 SOUTHWEST BLVD, TULSA, OK 74107-2726
- **Mailing address phone:** (918) 561-1700
- **Mailing address fax:** (918) 561-1701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2019
- **Last updated:** 05/09/2019