Organization
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN L MADDY (CEO OU PHYSICIANS)
(405) 271-3932
Entity
Organization
Contact information
Practice address
1919 S WHEELING AVE STE 600, OU PHYSICIANS TULSA SURGICAL SPECIALIST, TULSA, OK 74104-5635
(918) 634-7500
(918) 634-7560
Mailing address
4502 E 41ST ST # 2G08, OU PHYSICIANS TULSA-CLINICAL SERVICES, TULSA, OK 74135-2553
(918) 660-3632
(918) 660-3631
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100745010A
—
OK
Enumeration date
06/28/2007
Last updated
07/05/2013
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