NPIMap

Organization Active NPI

Tulsa Medical Laboratory, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Tulsa, OK
National Provider Identifier
1063743052
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
TULSA MEDICAL LABORATORY, LLC
Practice address
6565 S Yale Ave
Suite 410
Tulsa, OK 74136-8327
Phone
(918) 481-7859
Fax
(918) 747-7831
NPI assigned
Jan 15, 2010
Last updated
Jan 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Authorized official

Name
Rick D Gillis
Title
Business Manager
Phone
(918) 712-5571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

6565 S Yale Ave
Suite 410
Tulsa, OK 74136-8327

Mailing address

2738 E 51St St
Suite 290
Tulsa, OK 74105-6231
Phone (918) 712-5571

National Provider Directory

National Provider Directory

Locations

5110 S Yale Ave
Ste 100
Tulsa, OK 74135
Phone (918) 712-5571

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1063743052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2738 E 51ST ST",
            "address_2": "SUITE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056231",
            "telephone_number": "918-712-5571",
            "fax_number": "918-747-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "address_2": "SUITE 410",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368327",
            "telephone_number": "918-481-7859",
            "fax_number": "918-747-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA MEDICAL LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "GILLIS",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "918-712-5571"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; 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.