Organization
OKLAHOMA STATE UNIVERSITY
Active
Parent organization
OKLAHOMA STATE UNIVERSITY
Other names
OSU PHYSICIANS, OSU Addiction Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
OKLAHOMA STATE UNIVERSITY
Authorized official
ERIC JOHN POLAK (VP ADMINISTRATIVE AFFAIRS)
(918) 561-8422
Entity
Organization
Contact information
Practice address
5310 E 31ST ST STE 1102, TULSA, OK 74135-5018
(918) 561-1890
(918) 561-1889
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2022
Last updated
10/28/2024
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