Organization
PAIN INSTITUTE OF TULSA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND F SORENSEN DO (OWNER)
(918) 496-5195
Entity
Organization
Contact information
Practice address
1145 S UTICA AVE, SUITE 364, TULSA, OK 74104-4004
(918) 496-5195
(918) 496-5194
Mailing address
1145 S UTICA AVE, SUITE 364, TULSA, OK 74104-4004
(918) 496-5195
(918) 496-5194
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1434
OK
174400000X
Specialist
Primary
1732
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200088040A
—
OK
Enumeration date
08/31/2006
Last updated
06/25/2009
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