Individual
BART RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2950 S ELM PL, STE 160, BROKEN ARROW, OK 74012-7877
(918) 449-3750
(918) 449-3755
Mailing address
6600 S YALE AVE, STE 1400, TULSA, OK 74136-3310
(918) 488-6001
(918) 488-6010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3596
OK
Other
Enumeration date
02/07/2006
Last updated
02/28/2008
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