Individual
DR. PAUL ANTHONY BEVILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1802 E 19TH ST, 400, TULSA, OK 74104-5425
(918) 748-7644
(918) 293-3184
Mailing address
1611 S UTICA AVE, PMB 217, TULSA, OK 74104-4909
(918) 744-2618
(918) 293-3184
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17304
OK
Other
Enumeration date
04/04/2006
Last updated
11/30/2007
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