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Organization

SOUTH TULSA ASC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TERRANCE WADE O'NEAL (OWNER/PARTNER)
(623) 764-2780
Entity
Organization

Contact information

Practice address
9840 E 81ST ST STE 200, TULSA, OK 74133-4584
(623) 764-2780
Mailing address
20235 N CAVE CREEK RD # 104-472, PHOENIX, AZ 85024-4424
(623) 764-2780

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
03/26/2019
Last updated
03/26/2019
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