Individual
CARLY ANN DYKSTRA KUBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6151 S YALE AVE, TULSA, OK 74136-1907
(918) 502-6097
(918) 502-6046
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
36089
OK
Other
Enumeration date
05/16/2014
Last updated
08/04/2020
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