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Individual

DIANE PENSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3218 S 79TH EAST AVE, SUITE 300, TULSA, OK 74145-1316
(918) 728-6800
(918) 728-6801
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19802
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100091270D
OK
Enumeration date
01/09/2006
Last updated
12/28/2011
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