Provider Demographics
NPI:1548343460
Name:BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Entity type:Organization
Organization Name:BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO OU PHYSICIANS
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-660-3081
Mailing Address - Street 1:4502 E, 41ST STREET, 2G08
Mailing Address - Street 2:OU PHYSICIANS TULSA-CLINICAL SERVICES
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2553
Mailing Address - Country:US
Mailing Address - Phone:918-660-3632
Mailing Address - Fax:918-660-3631
Practice Address - Street 1:1809 E 13TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4419
Practice Address - Country:US
Practice Address - Phone:918-582-6800
Practice Address - Fax:918-582-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty