Organization
OSU CENTER FOR HEALTH SCIENCES
Active
Other names
OSU-AJ UTICA PARK CLINIC GASTROENTEROLOGY
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
1145 S UTICA AVE STE 701, TULSA, OK 74104-4019
(918) 734-4137
(918) 561-5747
Mailing address
1716 S PHOENIX AVE, TULSA, OK 74107-1850
(918) 561-8306
(918) 561-5747
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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