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Individual

MATTHEW THOMAS PRIEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 582-1980
(918) 561-1289
Mailing address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 582-1980
(918) 561-1289

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
7124
OK
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200960830A
OK
01
7124
LICENSE
OK
Enumeration date
03/28/2019
Last updated
11/26/2024
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