Individual
DR. KENNETH DANIEL OSTMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6600 S YALE AVE STE 600, TULSA, OK 74136-3363
(918) 491-5990
(918) 488-6673
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 502-8210
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7023
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201081560A
—
OK
05
—
201081560B
—
OK
Enumeration date
04/07/2019
Last updated
04/05/2024
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