Board of Regents of the University of Oklahoma Ou Physicians Tulsa

Organization Active NPI Family Medicine Physician · Tulsa, OK

NPI 1184872004 · NPPES record last updated Sep 4, 2008

Key facts

NPI
1184872004
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Practice address
619 S. Quincy Ave.
Ouptch-Laura Dester Shelter
Tulsa, OK 74120
Phone
(918) 660-3632
Fax
(918) 660-3631
NPI assigned
Sep 4, 2008
Organization subpart
No

Authorized official

Name
Brian L Maddy
Title
Ceo Ou Physicians
Phone
(405) 271-3932

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Board of Regents of the (53 organizations share this tax ID)

Locations

619 S Quincy Ave
Tulsa, OK 74120
Phone (918) 430-5616

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X

Addresses

Primary practice location

619 S. Quincy Ave.
Ouptch-Laura Dester Shelter
Tulsa, OK 74120

Mailing address

4502 E 41St Street, 2G08
Ou Physicians Tulsa-Clinical Services
Tulsa, OK 74135-2529
Phone (918) 660-3632

Other providers in Tulsa, OK

All providers in Tulsa, OK · Family Medicine Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.