Organization
METRO TULSA FOOT & ANKLE SPECIALIST PLLC
Active
Other names
Metro Tulsa Foot & Ankle Specialist PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA JO JAMISON (OFFICE MANAGER)
(918) 494-2902
Entity
Organization
Contact information
Practice address
3627 S HARVARD AVE, TULSA, OK 74135-2227
(918) 494-2902
(918) 494-2905
Mailing address
3627 S HARVARD AVE, TULSA, OK 74135-2227
(918) 477-4855
(918) 301-0088
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
154
OK
332B00000X
Durable Medical Equipment & Medical Supplies
154
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1168810005
DME PTAN
OK
01
—
1720467483
DME NPI
OK
01
—
731510850
TAX ID
OK
Enumeration date
05/27/2015
Last updated
07/21/2022
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