| Board Of Regents Of The University Of Oklahoma Ou Physicians Tulsa | |
|
4502 E 41st St Tulsa OK 74135-2553 | |
| (918) 660-3632 | |
| (918) 660-3631 |
| Full Name | Board Of Regents Of The University Of Oklahoma Ou Physicians Tulsa |
|---|---|
| Speciality | Clinic/Center |
| Location | 4502 E 41st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Jonathan E Joiner (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 9186603081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Regents Of The University Of Oklahoma Ou Physicians Tulsa 4502 E 41st St 2g08 Ou Physicians Tulsa Clinical Services Tulsa OK 74135-2553 Ph: (918) 660-3632 | Board Of Regents Of The University Of Oklahoma Ou Physicians Tulsa 4502 E 41st St Tulsa OK 74135-2553 Ph: (918) 660-3632 |
| NPI Number | 1154385730 |
|---|---|
| Provider Enumeration Date | 04/12/2006 |
| Last Update Date | 08/29/2022 |
| Medicare PECOS PAC ID | 5395645329 |
|---|---|
| Medicare Enrollment ID | O20040113000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154385730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Mark Harman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811967276 PECOS PAC ID: 4880595305 Enrollment ID: I20040117000077 |
| Provider Name | Deborah L Greubel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316917776 PECOS PAC ID: 6305747825 Enrollment ID: I20040117000102 |
| Provider Name | Lamont E Cavanagh |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1336111210 PECOS PAC ID: 1355242587 Enrollment ID: I20040120000258 |
| Provider Name | Kristina M Kline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568434447 PECOS PAC ID: 4981505138 Enrollment ID: I20040120000320 |
| Provider Name | Bryan Touchet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922078336 PECOS PAC ID: 4981505047 Enrollment ID: I20040120000905 |
| Provider Name | Thomas K Hoskison |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1598735953 PECOS PAC ID: 9234030396 Enrollment ID: I20040120000922 |
| Provider Name | Michael A Weisz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326018730 PECOS PAC ID: 7113829185 Enrollment ID: I20040121001133 |
| Provider Name | Martina Jelley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427028885 PECOS PAC ID: 1254233125 Enrollment ID: I20040121001154 |
| Provider Name | James E Crutcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740253129 PECOS PAC ID: 1254232259 Enrollment ID: I20040122000127 |
| Provider Name | John W Tipton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316937220 PECOS PAC ID: 7214830769 Enrollment ID: I20040130000880 |
| Provider Name | Ondria C Gleason |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255301651 PECOS PAC ID: 6507752144 Enrollment ID: I20040223000436 |
| Provider Name | Pranay Kathuria |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073583431 PECOS PAC ID: 8921080896 Enrollment ID: I20040603001160 |
| Provider Name | Karen Gold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518925692 PECOS PAC ID: 9638151129 Enrollment ID: I20040610001487 |
| Provider Name | William M Woods |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831296219 PECOS PAC ID: 0648258327 Enrollment ID: I20040709000415 |
| Provider Name | Stuart Hoff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932212578 PECOS PAC ID: 3072587567 Enrollment ID: I20040826000005 |
| Provider Name | Laura J Chalmers |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710046156 PECOS PAC ID: 5193791879 Enrollment ID: I20040903000363 |
| Provider Name | Frances K Wen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083686976 PECOS PAC ID: 9931163532 Enrollment ID: I20041115000071 |
| Provider Name | Leslie Janelle Whitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801867965 PECOS PAC ID: 9739144825 Enrollment ID: I20041201000009 |
| Provider Name | John C Vallandigham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265438501 PECOS PAC ID: 1557324241 Enrollment ID: I20050210000394 |
| Provider Name | Stephen T Calvert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902875420 PECOS PAC ID: 9234175969 Enrollment ID: I20050830000817 |
| Provider Name | Mary E Steward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235109646 PECOS PAC ID: 7012948441 Enrollment ID: I20051110000292 |
| Provider Name | Michael A Gold |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1376511956 PECOS PAC ID: 5597789115 Enrollment ID: I20060123000620 |
| Provider Name | Kristy M Griffith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326054206 PECOS PAC ID: 3375643489 Enrollment ID: I20070702000520 |
| Provider Name | Robert E Mitchell |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1164563631 PECOS PAC ID: 3375634231 Enrollment ID: I20070807000217 |
| Provider Name | Oliver A Cerqueira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538295423 PECOS PAC ID: 4486746260 Enrollment ID: I20070824000164 |
| Provider Name | John M Carment |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1013129329 PECOS PAC ID: 2365479359 Enrollment ID: I20070825000086 |
| Provider Name | Dana L Greer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699752154 PECOS PAC ID: 6507950771 Enrollment ID: I20070919000153 |
| Provider Name | David Herbert Jelley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649257569 PECOS PAC ID: 5799862520 Enrollment ID: I20080404000007 |
| Provider Name | Bernadette M Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891821708 PECOS PAC ID: 2668548876 Enrollment ID: I20080911000262 |
| Provider Name | Louis Lepak |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568519072 PECOS PAC ID: 1153484555 Enrollment ID: I20090112000401 |
| Provider Name | Thomas J Kern |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1386783553 PECOS PAC ID: 8224191473 Enrollment ID: I20090114000156 |
| Provider Name | Rocky Sowards |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245471630 PECOS PAC ID: 4486703659 Enrollment ID: I20090518000415 |
| Provider Name | Estacia Diann Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316196959 PECOS PAC ID: 4981756640 Enrollment ID: I20090710000491 |
| Provider Name | Annlyn Armstrong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376783738 PECOS PAC ID: 6406900190 Enrollment ID: I20090814000226 |
| Provider Name | Jessica Tsotsoros |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134305840 PECOS PAC ID: 2769529411 Enrollment ID: I20091028000728 |
| Provider Name | John E Cattaneo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497786057 PECOS PAC ID: 2860594694 Enrollment ID: I20091102000470 |
| Provider Name | Eric W Sherburn |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1306808316 PECOS PAC ID: 2062457278 Enrollment ID: I20100325000045 |
| Provider Name | Dru C Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730407263 PECOS PAC ID: 8820121668 Enrollment ID: I20100730000869 |
| Provider Name | William H Nesbit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083887798 PECOS PAC ID: 6507990314 Enrollment ID: I20100816000935 |
| Provider Name | Jana Dianne Bingman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801073663 PECOS PAC ID: 9335209659 Enrollment ID: I20110204000780 |
| Provider Name | Ashley E Walker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033348412 PECOS PAC ID: 3870757958 Enrollment ID: I20120621000449 |
| Provider Name | Leslie S Staubus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871757476 PECOS PAC ID: 7214177211 Enrollment ID: I20130716000677 |
| Provider Name | Angela D Bolz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013119650 PECOS PAC ID: 6608903265 Enrollment ID: I20130829000115 |
| Provider Name | Krishna Baradhi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538360573 PECOS PAC ID: 6800948779 Enrollment ID: I20130917000787 |
| Provider Name | Monica S Henning |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306046271 PECOS PAC ID: 7911177837 Enrollment ID: I20131025000540 |
| Provider Name | Tara R Buck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023266673 PECOS PAC ID: 3072748060 Enrollment ID: I20131029000788 |
| Provider Name | Kelly D Stemm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477789923 PECOS PAC ID: 9234282104 Enrollment ID: I20131105001342 |
| Provider Name | Paul Benson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922038348 PECOS PAC ID: 6305861436 Enrollment ID: I20131114001658 |
| Provider Name | Lauren Kimberly Conway |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487944104 PECOS PAC ID: 6305064882 Enrollment ID: I20140825001976 |
| Provider Name | Jason William Deck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902126188 PECOS PAC ID: 9638301724 Enrollment ID: I20141117000017 |
| Provider Name | Lisa Lee Duckett |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1730444746 PECOS PAC ID: 0648597880 Enrollment ID: I20150326001659 |
| Provider Name | David B Ross |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952690893 PECOS PAC ID: 5799916169 Enrollment ID: I20150814013490 |
| Provider Name | Manisha Ahuja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518132877 PECOS PAC ID: 5698833606 Enrollment ID: I20151021000637 |
| Provider Name | Ama Karikari |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649560855 PECOS PAC ID: 4486963063 Enrollment ID: I20151021002674 |
| Provider Name | Matthew Tandy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104054469 PECOS PAC ID: 6305155995 Enrollment ID: I20151021003070 |
| Provider Name | Kimberlee Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306134929 PECOS PAC ID: 3678890563 Enrollment ID: I20151028000072 |
| Provider Name | Narottam Regmi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1427347947 PECOS PAC ID: 5496923138 Enrollment ID: I20160603000551 |
| Provider Name | Tessa Leigh Manning |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508025388 PECOS PAC ID: 8820245111 Enrollment ID: I20160615000295 |
| Provider Name | Brent Wayne Beasley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043278484 PECOS PAC ID: 4981632106 Enrollment ID: I20160627000055 |
| Provider Name | Jennifer R Weakley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932542404 PECOS PAC ID: 9830412279 Enrollment ID: I20160808000050 |
| Provider Name | Andrew Liew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316176340 PECOS PAC ID: 4183918154 Enrollment ID: I20160815000772 |
| Provider Name | Jameca Price |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780818575 PECOS PAC ID: 4486896370 Enrollment ID: I20160822000312 |
| Provider Name | Hannah Hargis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568883155 PECOS PAC ID: 9032491345 Enrollment ID: I20170123000226 |
| Provider Name | Viviane Elisabeth De Souza Santos Santos Sachs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720428451 PECOS PAC ID: 8527358936 Enrollment ID: I20170220000451 |
| Provider Name | Jacob Raymond O Meilia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942442512 PECOS PAC ID: 4688892706 Enrollment ID: I20170621001587 |
| Provider Name | Geoffrey Chow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447483565 PECOS PAC ID: 9234449141 Enrollment ID: I20170810002666 |
| Provider Name | Deborah Mohamad Ali |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922428770 PECOS PAC ID: 0446522080 Enrollment ID: I20170817000607 |
| Provider Name | Audrey Corbett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922364801 PECOS PAC ID: 4385862291 Enrollment ID: I20170830000470 |
| Provider Name | Peter Richard Nelson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1043209307 PECOS PAC ID: 8224094206 Enrollment ID: I20180111001271 |
| Provider Name | Sandra Scott Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609371392 PECOS PAC ID: 5799049144 Enrollment ID: I20180510001862 |
| Provider Name | John Patick Laurent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548689110 PECOS PAC ID: 5698020485 Enrollment ID: I20180619002915 |
| Provider Name | Shelly Bowles Mercer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1770840126 PECOS PAC ID: 0749430106 Enrollment ID: I20180718001396 |
| Provider Name | Rui Mao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306223268 PECOS PAC ID: 8022320043 Enrollment ID: I20180806000017 |
| Provider Name | Kyle J Bielefeld |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821268707 PECOS PAC ID: 5092067801 Enrollment ID: I20181005001168 |
| Provider Name | Heather Marie Kitchen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801230610 PECOS PAC ID: 6002168788 Enrollment ID: I20181008001273 |
| Provider Name | Bren Jelea Ulberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467766717 PECOS PAC ID: 4587918032 Enrollment ID: I20181119003338 |
| Provider Name | Blake J Lesselroth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801997390 PECOS PAC ID: 0648441139 Enrollment ID: I20190204000545 |
| Provider Name | Kelly K Kempe |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1972763704 PECOS PAC ID: 3072828730 Enrollment ID: I20190211000650 |
| Provider Name | Laura C Campion |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265523476 PECOS PAC ID: 5294736773 Enrollment ID: I20190503000243 |
| Provider Name | Kevin B Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518320928 PECOS PAC ID: 3971837220 Enrollment ID: I20190620002387 |
| Provider Name | Zhamak Khorgami |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902243470 PECOS PAC ID: 4284940628 Enrollment ID: I20190716003249 |
| Provider Name | Caroline Michele Markey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255726360 PECOS PAC ID: 8527361062 Enrollment ID: I20190919000054 |
| Provider Name | Lauren Jennette Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386099166 PECOS PAC ID: 2163752668 Enrollment ID: I20190926000771 |
| Provider Name | Brian Geoffrey Hall |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851596217 PECOS PAC ID: 1759640709 Enrollment ID: I20190930001358 |
| Provider Name | Brett Wilkinson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1194363606 PECOS PAC ID: 0648606780 Enrollment ID: I20200207001640 |
| Provider Name | Jamie Doreen Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619330099 PECOS PAC ID: 6406119775 Enrollment ID: I20200527000277 |
| Provider Name | Ryan John Yarnall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861925224 PECOS PAC ID: 5799107975 Enrollment ID: I20200616002085 |
| Provider Name | Todd Hasenstein |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588046379 PECOS PAC ID: 9234463241 Enrollment ID: I20200812000615 |
| Provider Name | Simone Bigelow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639603137 PECOS PAC ID: 3971929845 Enrollment ID: I20200824000318 |
| Provider Name | Kimberly Cassendre Zamor |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1518258136 PECOS PAC ID: 3577878610 Enrollment ID: I20200911000310 |
| Provider Name | Morgan N Richards |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346603560 PECOS PAC ID: 6406149574 Enrollment ID: I20200915000924 |
| Provider Name | Jesse Richards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598112823 PECOS PAC ID: 7012203771 Enrollment ID: I20200915002200 |
| Provider Name | Hilary Redemann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053708701 PECOS PAC ID: 5597077362 Enrollment ID: I20200928001570 |
| Provider Name | Lakia Dawn Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740730894 PECOS PAC ID: 7214347509 Enrollment ID: I20201027001596 |
| Provider Name | Brianna Nicole Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184232753 PECOS PAC ID: 8729499124 Enrollment ID: I20201116000525 |
| Provider Name | Tyler R Sparkman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689080665 PECOS PAC ID: 9537573142 Enrollment ID: I20210121002970 |
| Provider Name | Michael Nelson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437344181 PECOS PAC ID: 6406944990 Enrollment ID: I20210204001689 |
| Provider Name | Mohd Qutob |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679952584 PECOS PAC ID: 0244533842 Enrollment ID: I20210323002813 |
| Provider Name | Alberto Benjamin Chong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336645621 PECOS PAC ID: 2163824780 Enrollment ID: I20210706000806 |
| Provider Name | Dru Clanton Albin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487151619 PECOS PAC ID: 4981006517 Enrollment ID: I20210706001153 |
| Provider Name | Starr Jennifer Harmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205323953 PECOS PAC ID: 0648672030 Enrollment ID: I20210707003201 |
| Provider Name | Deandra Lynette Antwine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295404994 PECOS PAC ID: 6901294289 Enrollment ID: I20211020000688 |
| Provider Name | Edward Cho |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336453406 PECOS PAC ID: 7214200104 Enrollment ID: I20211108000288 |
| Provider Name | Matthew Austin Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508284563 PECOS PAC ID: 2365744026 Enrollment ID: I20211129001061 |
| Provider Name | Vicky B Cha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548931546 PECOS PAC ID: 0648660761 Enrollment ID: I20211204000110 |
| Provider Name | Jordan Anjelica Parsons |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942863162 PECOS PAC ID: 1557755253 Enrollment ID: I20220223000337 |
| Provider Name | Nisha Singh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467614818 PECOS PAC ID: 1951713643 Enrollment ID: I20220428001120 |
| Provider Name | Caleb D Hurst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285298935 PECOS PAC ID: 2163806647 Enrollment ID: I20220901000797 |
| Provider Name | Lateef Olasunkanmi Lawal |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356726335 PECOS PAC ID: 5890038665 Enrollment ID: I20220906002473 |
| Provider Name | Raye Reeder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437611498 PECOS PAC ID: 2961887609 Enrollment ID: I20220916001912 |
| Provider Name | Ky G Dorsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104054451 PECOS PAC ID: 4688964240 Enrollment ID: I20220919003331 |
| Provider Name | Mallory Jo Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528528411 PECOS PAC ID: 9638555378 Enrollment ID: I20221003002361 |
| Provider Name | Prashanth S Iyer |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1710417092 PECOS PAC ID: 9638555394 Enrollment ID: I20221003002921 |
| Provider Name | Crysta J Chatman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124382189 PECOS PAC ID: 5294043493 Enrollment ID: I20221010000671 |
| Provider Name | Nasser Alamiri |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1780027896 PECOS PAC ID: 8527380898 Enrollment ID: I20221012002187 |
| Provider Name | Erin N Jorgensen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043579774 PECOS PAC ID: 5395033484 Enrollment ID: I20221121001573 |
| Provider Name | Julie Delane Harmon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699404327 PECOS PAC ID: 8022489327 Enrollment ID: I20230124003602 |
| Provider Name | Nicole S Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982313292 PECOS PAC ID: 6608247622 Enrollment ID: I20230130000611 |
| Provider Name | Fernando Motta |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1972166437 PECOS PAC ID: 3870836091 Enrollment ID: I20230731002090 |
| Provider Name | Amanda Watson Gibson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649803222 PECOS PAC ID: 5092178699 Enrollment ID: I20230830001255 |
| Provider Name | Jocelyn Anne Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588293344 PECOS PAC ID: 2668836883 Enrollment ID: I20230906003780 |
| Provider Name | Jessica Sumner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487004941 PECOS PAC ID: 1153745039 Enrollment ID: I20230908001845 |
| Provider Name | Helga K Skaftason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285255349 PECOS PAC ID: 8921453630 Enrollment ID: I20231016003500 |
| Provider Name | Stacey Kubovec |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245762673 PECOS PAC ID: 3779860440 Enrollment ID: I20231128001275 |
| Provider Name | Tyler Franklin Wines |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1619531175 PECOS PAC ID: 2961736608 Enrollment ID: I20231206001933 |
| Provider Name | Jessica Nicole Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174397509 PECOS PAC ID: 0143679092 Enrollment ID: I20231218001995 |
Tulsa Internal Medicine Physicians, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2000 S Wheeling Ave, Ste 1000, Tulsa, OK 74104 Phone: 918-748-8467 | |
Family Health And Wellness Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 Phone: 918-740-4630 Fax: 918-289-0091 | |
Family Medical Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4134 S Harvard Ave Ste B3, Tulsa, OK 74135 Phone: 918-442-2236 Fax: 918-794-2333 | |
Community Health Connection, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13702 E 46th Pl, Tulsa, OK 74134 Phone: 918-622-0641 Fax: 918-622-4814 | |
Qt Quikmed Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4705 S 129th East Ave, Tulsa, OK 74134 Phone: 918-994-3953 | |
Sunshine Care Partners Of Dfw Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1532 S Peoria Ave, Tulsa, OK 74120 Phone: 918-609-5600 | |
Careatc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 N 161st East Ave, Tulsa, OK 74116 Phone: 800-993-8244 |