Individual
BRENT DEAN HARTSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2553
(918) 744-3482
Mailing address
4142 S MINGO RD, TULSA, OK 74146-3632
(918) 744-2553
(918) 744-3482
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
04-23927
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
18120
OK
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
H4387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100158850A
—
KS
05
—
100169690A
—
OK
05
—
1978
—
OK
Enumeration date
07/17/2006
Last updated
06/30/2020
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