| South Tulsa Medical Group Llc | |
|
8803 S 101st East Ave Ste 100 Tulsa OK 74133-5726 | |
| (918) 392-5470 | |
| Not Available |
| Full Name | South Tulsa Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8803 S 101st East Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Debbie 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 |
|---|---|
| South Tulsa Medical Group Llc 7100 Commerce Way Suite 180 Brentwood TN 37027-2829 Ph: () - | South Tulsa Medical Group Llc 8803 S 101st East Ave Ste 100 Tulsa OK 74133-5726 Ph: (918) 392-5470 |
| NPI Number | 1518998483 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 09/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518998483 | NPI | - | NPPES |
| 200106940A | Medicaid | OK |
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