Individual
JOHN C. BALBAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Mailing address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
26150
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OK400804
MEDICARE PTAN
OK
Enumeration date
04/04/2007
Last updated
10/13/2008
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