| Broken Arrow Medical Group LLC | |
|
9001 S. 101st E. Ave Ste 350 Tulsa OK 74133 | |
| (918) 392-5500 | |
| Not Available |
| Full Name | Broken Arrow Medical Group LLC |
|---|---|
| Speciality | General Practice |
| Location | 9001 S. 101st E. Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Debbie T Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Arrow Medical Group LLC Po Box 689022 Franklin TN 37068-9022 Ph: (888) 287-7705 | Broken Arrow Medical Group LLC 9001 S. 101st E. Ave Ste 350 Tulsa OK 74133 Ph: (918) 392-5500 |
| NPI Number | 1386676153 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 06/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386676153 | NPI | - | NPPES |
| 200100460A | Medicaid | OK |
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