Individual
MICHAEL D LANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10507 E 91ST ST STE 450, TULSA, OK 74133-5515
(918) 307-3170
(918) 307-3171
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
N3810
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
3862
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
N3810
TX
207X00000X
Orthopaedic Surgery Physician
N3810
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
19051
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06008071
—
MS
05
—
1418153
—
LA
01
—
3442570
AMERICAN ADMIN GROUP
MS
01
—
8CG326
BCBS
TX
01
—
P00308321
RAILROAD MEDICARE
—
Enumeration date
08/18/2006
Last updated
07/29/2021
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