Organization
UTICA WOMEN'S SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE J PARHAM (CHIEF FINANCIAL OFFICER)
(918) 749-1413
Entity
Organization
Contact information
Practice address
1725 E 19TH ST, SUITE 401, TULSA, OK 74104-5437
(918) 749-1413
(918) 749-0234
Mailing address
1725 E 19TH ST STE 401, TULSA, OK 74104-5409
(918) 749-1413
(918) 749-0234
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200747340A
—
OK
Enumeration date
05/04/2017
Last updated
07/11/2022
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