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Individual

MICHAEL J FOGLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 748-7650
(918) 403-6341
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 748-7650
(918) 403-6341

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
24626
OK
207RC0000X
Cardiovascular Disease Physician
Primary
24626
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200064990A
OK
01
P00248890
MEDICARE RAILROAD
OK
Enumeration date
01/27/2006
Last updated
03/08/2018
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