| Osu-aj Triton Health, Pllc | |
|
128 West Main Vian OK 74962-0446 | |
| (918) 773-5228 | |
| (918) 773-8482 |
| Full Name | Osu-aj Triton Health, Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 128 West Main, Vian, Oklahoma |
| Authorized Official Name and Position | Eric Polak (CFO OSU PHYSICIANS) |
| Authorized Official Contact | 9185618422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Osu-aj Triton Health, Pllc 2345 Southwest Blvd Tulsa OK 74107-2705 Ph: (918) 561-8306 | Osu-aj Triton Health, Pllc 128 West Main Vian OK 74962-0446 Ph: (918) 773-5228 |
| NPI Number | 1356741078 |
|---|---|
| Provider Enumeration Date | 08/29/2014 |
| Last Update Date | 03/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356741078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
C. Patrick Sullivan,do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 North Thornton, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |
Triton Health Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 128 W. Main Street, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 |