Individual
CORNELIA O. MERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 582-1980
Mailing address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 561-5701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2541
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100248070B
—
OK
Enumeration date
03/16/2006
Last updated
04/13/2012
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