Individual
MAISON QUINN HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 582-1972
Mailing address
PO BOX 256, MULDROW, OK 74948-0256
(918) 235-4799
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
1018R
OK
390200000X
Student in an Organized Health Care Education/Training Program
1018R
OK
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/02/2023
Last updated
10/27/2025
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