NPIMap

Organization Active NPI

Osu Center for Health Sciences

Doing business as Osu-Aj Utica Park Clinic South Tulsa ENT

  • Clinic/Center
  • Tulsa, OK
National Provider Identifier
1366791857
Registry record updated Mar 21, 2016
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 Utica Park Clinic South Tulsa ENT
Practice address
8803 S. 101St E. Ave.
Suite 165
Tulsa, OK 74133-5750
Phone
(918) 561-8306
Fax
(918) 561-5747
NPI assigned
Aug 30, 2012
Last updated
Mar 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Authorized official

Name
Eric Polak
Title
Cfo Osu Physicians
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

8803 S. 101St E. Ave.
Suite 165
Tulsa, OK 74133-5750

Mailing address

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

Other names 1

  • OSU-AJ UTICA PARK CLINIC SOUTH TULSA ENT Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2113758Utica Park Clinic Urology South8803 E 101St E Ave, Ste 300, Tulsa, OK 74133Certificate of waiverMay 30, 2028

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1366791857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SOUTHWEST BOULEVARD",
            "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": "8803 S. 101ST E. AVE.",
            "address_2": "SUITE 165",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335750",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU CENTER FOR HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CFO OSU PHYSICIANS",
        "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 UTICA PARK CLINIC SOUTH TULSA ENT",
            "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 Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.