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Organization

TULSA PEDIATRIC GROUP, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN M STEVENS M.D. (OWNER)
(918) 481-4750
Entity
Organization

Contact information

Practice address
6465 S YALE AVE STE 715, TULSA, OK 74136-7809
(918) 481-4750
(918) 481-4755
Mailing address
6465 S YALE AVE STE 715, TULSA, OK 74136-7809
(918) 481-4750
(918) 481-4755

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9951
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200087850A
OK
Enumeration date
03/08/2007
Last updated
01/12/2024
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