Organization
OSU CENTER FOR HEALTH SCIENCES
Active
Other names
OSU-AJ ON CALL PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JOHN POLAK (VICE PRESIDENT OF ADMIN/FINANCE)
(918) 561-8422
Entity
Organization
Contact information
Practice address
12150 E 96TH ST N STE 101, OWASSO, OK 74055-5339
(918) 561-8306
(918) 561-5747
Mailing address
700 N GREENWOOD AVE RM 372, TULSA, OK 74106-0702
(918) 561-8306
(918) 561-5747
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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