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Organization

AHS OKLAHOMA PHYSICIAN GROUP LLC

Active
Other names
Utica Park Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN C. PETROVICH (EVP GENERAL COUNSEL)
(615) 296-3594
Entity
Organization

Contact information

Practice address
1120 S UTICA AVE STE 100, TULSA, OK 74104-4012
(918) 579-3826
(918) 579-1262
Mailing address
340 SEVEN SPRINGS WAY STE 100, BRENTWOOD, TN 37027-5697
(615) 296-3594

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RI0200X
Infectious Disease Physician
207T00000X
Neurological Surgery Physician
207X00000X
Orthopaedic Surgery Physician
207Y00000X
Otolaryngology Physician
208000000X
Pediatrics Physician
2080P0006X
Developmental - Behavioral Pediatrics Physician
2080P0210X
Pediatric Nephrology Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
2084N0400X
Neurology Physician
208600000X
Surgery Physician
208800000X
Urology Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200044160A
OK
Enumeration date
05/18/2006
Last updated
04/06/2026
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