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Individual

KALA J OMSTEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
9001 S 101ST EAST AVE, STE 270, TULLSA, OK 74133-5711
(918) 392-7000
(918) 392-7013
Mailing address
9001 S 101ST EAST AVE, SUITE 270, TULSA, OK 74133-5711
(918) 392-7000
(918) 392-7013

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3526
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100097460C
OK
01
800522535
MEDICARE GROUP PIN
OK
Enumeration date
01/13/2006
Last updated
07/29/2013
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