Organization
KYLE J MANGELS MD, PLC
Active
Other names
Kyle J Mangels MD, PLC, KM Neurosurgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTNEY PAYNE (OFFICE MANAGER)
(918) 600-0327
Entity
Organization
Contact information
Practice address
6802 S OLYMPIA AVE STE 275, TULSA, OK 74132-1848
(918) 600-0327
(918) 732-9229
Mailing address
6802 S OLYMPIA AVE STE 275, TULSA, OK 74132-1848
(918) 600-0327
(918) 732-9229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138240A
—
OK
01
—
10885134
CAQH
OK
01
—
1902498686
MEDICARE
OK
Enumeration date
02/04/2021
Last updated
06/23/2022
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