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Find providers by NPI
Organization

STATE OF OKLAHOMA

Active
Other names
OSU Clinical Lab Services
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JARRAD R WAGNER PHD (ASSOCIATE PROFESSOR & DIRECTOR)
(918) 561-8247
Entity
Organization

Contact information

Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 561-1421
Mailing address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 561-1421

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
37D2076904
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200217940K
OK
Enumeration date
05/29/2014
Last updated
08/31/2017
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