Organization
SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY SLOAN (ASST OFFICE MANAGER)
(918) 301-2505
Entity
Organization
Contact information
Practice address
1725 E 19TH ST, SUITE 800, TULSA, OK 74104-5472
(918) 301-2505
(918) 744-3633
Mailing address
PO BOX 35307, TULSA, OK 74153-0307
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100729310A
—
OK
01
—
CD8640
RAILROAD MEDICARE
OK
Enumeration date
01/30/2007
Last updated
07/20/2011
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