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Organization
BOARD FO REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Active
Organization
BOARD FO REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN L MADDY (CEO OU PHYSICIANS)
(405) 271-3932
Entity
Organization
Contact information
Practice address
2325 SOUTH HARVARD STE 400A, OUTACH FAMILY & CHILDREN'S SERVICES, TULSA, OK 74114
(918) 660-3622
(918) 660-3611
Mailing address
4502 E 41ST ST 2G08, OU PHYSICIANS TULSA-CLINICAL SERVICES, TULSA, OK 74135-2527
(918) 660-3632
(918) 660-3631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100755890C
—
OK
Enumeration date
04/30/2008
Last updated
04/30/2008
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