Organization
AVALON PARK PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BRIAN RALEY MD (OWNER)
(918) 398-7170
Entity
Organization
Contact information
Practice address
6528 E 101ST ST, SUITE D-1, PMB 419, TULSA, OK 74133-6724
(918) 398-7170
(918) 398-7199
Mailing address
7779 EAST 106TH STREET, TULSA, OK 74133-6844
(918) 398-7170
(918) 398-7199
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20582
OK
Other
Enumeration date
04/18/2007
Last updated
08/22/2020
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