Organization
SOUTHERN OKLAHOMA INTERNAL MEDICINE P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARBARA K TULEY M.D. (PRESIDENT)
(580) 436-4495
Entity
Organization
Contact information
Practice address
307 N MONTE VISTA ST, ADA, OK 74820-4607
(580) 436-4495
(580) 436-4499
Mailing address
307 N MONTE VISTA ST, ADA, OK 74820-4607
(580) 436-4495
(580) 436-4499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17220
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500648296001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
02/21/2007
Last updated
12/10/2007
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