NPIMap

Organization Active NPI

Osu Center for Health Sciences

Doing business as Osu-Aj Susan B. Young DO PLC

  • Clinic/Center
  • Broken Arrow, OK
National Provider Identifier
1023542875
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OSU CENTER FOR HEALTH SCIENCES
Doing business as
Osu-Aj Susan B. Young DO PLC
Practice address
4700 W Urbana St
Broken Arrow, OK 74012-5504
Phone
(918) 561-8306
Fax
(918) 561-5747
NPI assigned
Apr 19, 2017
Last updated
Apr 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eric Polak
Title
Vice President for Admin/Finance
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4700 W Urbana St
Broken Arrow, OK 74012-5504

Mailing address

2345 Southwest Blvd
Tulsa, OK 74107-2705
Phone (918) 561-8306

Other names 1

  • OSU-AJ SUSAN B. YOUNG DO PLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma State University221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1023542875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SOUTHWEST BLVD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741072705",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W URBANA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125504",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU CENTER FOR HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR ADMIN/FINANCE",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU-AJ SUSAN B. YOUNG DO PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.