Organization
OSU CENTER FOR HEALTH SCIENCES
Active
Other names
OSU-AJ PREMIER PEDIATRICS OF MUSKOGEE
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC POLAK (VICE PRESIDENT FOR ADMIN/FINANCE)
(918) 561-8422
Entity
Organization
Contact information
Practice address
2009 N MAIN ST, MUSKOGEE, OK 74401-4131
(918) 816-4024
(918) 816-4025
Mailing address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 561-8306
(918) 561-5747
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/30/2015
Last updated
03/02/2016
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