Phoenix Medical Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHOENIX MEDICAL LAB LLC

Practice address

6312 E 101St St
Tulsa, OK 74137-7007

Phone

(918) 438-7840

Fax

(918) 528-6648

NPI assigned

Jan 5, 2024

Organization subpart

No

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

Authorized official

Name

Mr. John Alan Jones

Title

Co-Owner

Phone

(817) 271-1970

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1104696517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6312 E 101ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377007",
            "telephone_number": "918-438-7840",
            "fax_number": "918-528-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 E 101ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377007",
            "telephone_number": "918-438-7840",
            "fax_number": "918-528-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "817-271-1970",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Phoenix Healthcare LLC
• Phoenix Healthcare LLC
• Phoenix Healthcare LLC
• Phoenix Rehab, LLC
• James Timothy Phoenix II, MD
• PHP Ok PC
• Binh Thai Phung, D.O.
• Physical Rehabilitation Center Inc.

• Clinical Medical Laboratory in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinical Medical Laboratory in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.