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Organization

THE ORTHOPAEDIC CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN CLARY (CEO)
(918) 925-3224
Entity
Organization

Contact information

Practice address
8803 S 101ST EAST AVE, SUITE 100, TULSA, OK 74133-5726
(918) 301-3160
Mailing address
1809 E 13TH ST, SUITE 100, TULSA, OK 74104-4419
(918) 582-6800

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
363AS0400X
Surgical Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100746990A
OK
Enumeration date
03/28/2014
Last updated
05/12/2021
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