Organization
CHILD NEUROLOGY OF TULSA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JONATHAN SIEGLER M.D. (PRESIDENT OWNER)
(918) 493-3300
Entity
Organization
Contact information
Practice address
6465 S YALE AVE, STE 320, TULSA, OK 74136-7823
(918) 493-3300
(918) 493-3315
Mailing address
6465 S YALE AVE, STE 320, TULSA, OK 74136-7823
(918) 493-3300
(918) 493-3315
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19880
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213720B
—
OK
Enumeration date
05/05/2010
Last updated
05/05/2010
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