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Organization
SOUTH TULSA RETINA
Active
Organization
SOUTH TULSA RETINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY PHILLIPS (DIRECTOR OF BUSINESS AFFAIRS)
(918) 893-9240
Entity
Organization
Contact information
Practice address
9940 E 81ST ST, TULSA, OK 74133-4501
(918) 893-9240
Mailing address
9940 E 81ST ST, TULSA, OK 74133-4501
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
NULL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
207WX0120X
Cornea and External Diseases Specialist Physician
—
NULL
207WX0120X
Cornea and External Diseases Specialist Physician
—
—
Other
Enumeration date
03/26/2019
Last updated
11/27/2023
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