Organization
OKLAHOMA STATE UNIVERSITY
Active
Other names
OSU Physicians Family Medicine Eastgate
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JOHN POLAK (VP)
(918) 561-8422
Entity
Organization
Contact information
Practice address
14002 E 21ST ST STE 1130, TULSA, OK 74134-1408
(918) 439-1200
(918) 439-1199
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 585-9273
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306882261
OSU GROUP NPI
—
Enumeration date
01/28/2010
Last updated
02/18/2026
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