Organization
NEW LIFE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW D ADCOCK (VP)
(918) 932-2057
Entity
Organization
Contact information
Practice address
5018 E 68TH ST, TULSA, OK 74136
(918) 932-2057
(918) 932-2058
Mailing address
5018 E 68TH ST, TULSA, OK 74136-3367
(918) 932-2057
(918) 932-2058
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28118170A
—
OK
Enumeration date
02/05/2016
Last updated
02/05/2016
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