# BELLHAVEN MEDICAL SPA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BELLHAVEN MEDICAL SPA, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992063655
- **Legal business name:** BELLHAVEN MEDICAL SPA, LLC
- **Authorized official:** FRANK WROBERSON BELL DO (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (918) 697-6889

## Contact information

- **Practice address:** 1878 E. 15TH ST., TULSA, OK 74104
- **Practice address phone:** (918) 938-7026
- **Practice address fax:** (918) 938-7748
- **Mailing address:** 1878 E. 15TH ST., TULSA, OK 74104
- **Mailing address phone:** (918) 938-7026
- **Mailing address fax:** (918) 938-7748

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 4173 | OK | Yes |

## Other

- **Enumeration date:** 05/01/2012
- **Last updated:** 05/01/2012