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Organization

TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC

Active
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Organization

TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOEL K GIST M.D. (PRESIDENT)
(918) 748-7620
Entity
Organization

Contact information

Practice address
1919 S WHEELING AVE, SUITE 304, TULSA, OK 74104-5638
(918) 748-7620
(918) 748-7647
Mailing address
1919 S WHEELING AVE, SUITE 304, TULSA, OK 74104-5638
(918) 748-7620
(918) 748-7647

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
06/03/2006
Last updated
08/22/2020
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