Individual
JOHN ANDREW MINIELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2553
(918) 744-3482
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2553
(918) 744-3482
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12642
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8280
—
OK
Enumeration date
07/24/2006
Last updated
07/09/2007
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