Organization
AESTHETIC SURGERY OF TULSA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E MITCHELL MD (PRESIDENT)
(918) 504-0364
Entity
Organization
Contact information
Practice address
6802 S OLYMPIA AVE, SUITE G113, TULSA, OK 74132-1823
(918) 960-3033
(918) 960-3035
Mailing address
11913 S SANDUSKY AVE, TULSA, OK 74137-1801
(918) 504-0364
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
22998
OK
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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