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Organization

NORTHEASTERN OKLAHOMA UROLOGY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CLARK TINGLEAF, M.D. M.D. (PHYSICIAN)
(918) 341-1311
Entity
Organization

Contact information

Practice address
201 W BLUE STARR DRIVE, CLAREMORE, OK 74017
(918) 341-1311
(918) 342-1634
Mailing address
201 W BLUE STARR DRIVE, CLAREMORE, OK 74017
(918) 341-1311
(918) 342-1634

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23509
OK

Other

Enumeration date
10/16/2006
Last updated
08/22/2020
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