Organization
DERMATOLOGY ASSOCIATES OF TULSA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD H YOB DO (OWNER PRESIDENT)
(918) 307-0215
Entity
Organization
Contact information
Practice address
8803 S 101ST E AVE, STE 335, TULSA, OK 74133-7550
(918) 307-0215
(918) 250-7669
Mailing address
8803 S 101ST E AVE, STE 335, TULSA, OK 74133-7550
(918) 307-0215
(918) 250-7669
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100749090B
—
OK
01
—
CH9137
RR MEDICARE
OK
Enumeration date
07/27/2006
Last updated
06/23/2011
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