Organization
OKLAHOMA STATE UNIVERISTY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWNA DUNCAN DO (PROGRAM DIRECTOR)
(918) 382-4600
Entity
Organization
Contact information
Practice address
717 S HOUSTON AVE, SUITE 400, TULSA, OK 74127-9023
(918) 382-4600
Mailing address
717 S HOUSTON AVE, SUITE 400, TULSA, OK 74127-9023
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
5986
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200652820
—
OK
Enumeration date
01/27/2017
Last updated
01/27/2017
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