Individual
MR. KYLE JOE MANGELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6802 S OLYMPIA AVE STE 275, TULSA, OK 74132-1848
(918) 600-0327
(918) 732-9229
Mailing address
6802 S OLYMPIA AVE, SUITE #275, TULSA, OK 74132-1848
(918) 600-0327
(918) 732-9229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22694
OK
207T00000X
Neurological Surgery Physician
22694
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138240A
—
OK
01
—
140008042
RAILROAD MEDICARE
OK
Enumeration date
04/03/2006
Last updated
05/09/2024
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