Individual
DR. POLY TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
Mailing address
7422 W 40TH ST, TULSA, OK 74107-4853
(918) 447-0495
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20986
OK
Other
Enumeration date
08/08/2006
Last updated
07/09/2007
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