Organization
OKLAHOMA STATE UNIVERSITY
Active
Other names
OSU Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JOHN POLAK (VP/CFO)
(918) 561-8422
Entity
Organization
Contact information
Practice address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 561-5701
(918) 585-9273
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100757080A
—
OK
Enumeration date
06/21/2006
Last updated
02/18/2026
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