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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