Osteopathic Medicine of Tulsa, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

3803 Issued in OK

Legal business name

OSTEOPATHIC MEDICINE OF TULSA, INC.

Practice address

6465 S Yale Ave
Ste 804
Tulsa, OK 74136-7823

Phone

(918) 694-0684

NPI assigned

Mar 16, 2009

Organization subpart

No

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

Authorized official

Name

Larry Lee Ellis Jr., D.O.

Title

Physician

Phone

(918) 694-0684

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1710128152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "STE 804",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-694-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "STE 804",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-694-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSTEOPATHIC MEDICINE OF TULSA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "918-694-0684",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "3803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Timothy Osmun
• Lisa Osmus, CCC-SLP
• Kenneth Osorio
• Rafael Osorio, LPN
• Osteopathic Cardiovascular Surg Inc
• Osteopathic Physicians of Tulsa, Inc
• Osteopathic Physicians of Tulsa, Inc.
• Kenneth Daniel Ostmo, DO
• Osu Cardiology
• Osu Center for Health Sciences

• Clinic/Center in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.