NPIMap

Organization Active NPI

Oklahoma State University

Doing business as OSU Physicians South Tulsa OBGYN

  • Medical Specialty Clinic/Center
  • Tulsa, OK
National Provider Identifier
1316437494
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
OKLAHOMA STATE UNIVERSITY
Doing business as
OSU Physicians South Tulsa OBGYN
Practice address
6126 E 61St St
Tulsa, OK 74136-2117
Phone
(918) 294-3430
Fax
(918) 294-3910
NPI assigned
May 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Eric John Polak
Title
VP
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

6126 E 61St St
Tulsa, OK 74136-2117

Mailing address

5310 E 31St St Ste 13
Tulsa, OK 74135-5013
Phone (918) 561-5701

Other names 1

  • OSU Physicians South Tulsa OBGYN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sallisaw State Veterans Home140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

8803 S 101st East Ave
Ste 210
Tulsa, OK 74133
Phone (918) 294-3430

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1316437494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355013",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-294-3430",
            "fax_number": "918-294-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU Physicians South Tulsa OBGYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 28, 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.