# BOARD FO REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA

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

## Provider details

- **NPI number:** 1902072960
- **Authorized official:** BRIAN L MADDY (CEO OU PHYSICIANS)
- **Authorized official phone:** (405) 271-3932

## Contact information

- **Practice address:** 2325 SOUTH HARVARD STE 400A, OUTACH FAMILY & CHILDREN'S SERVICES, TULSA, OK 74114
- **Practice address phone:** (918) 660-3622
- **Practice address fax:** (918) 660-3611
- **Mailing address:** 4502 E 41ST ST 2G08, OU PHYSICIANS TULSA-CLINICAL SERVICES, TULSA, OK 74135-2527
- **Mailing address phone:** (918) 660-3632
- **Mailing address fax:** (918) 660-3631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 04/30/2008
- **Last updated:** 04/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100755890C | — | OK |