Tulsa Otolaryngology Inc.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

7801 Issued in OK

Legal business name

TULSA OTOLARYNGOLOGY INC.

Practice address

1725 E 19TH St
Suite 100
Tulsa, OK 74104-5437

Phone

(918) 742-7376

Fax

(918) 743-2117

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Alen Munson Fuller, MDNPI 1164422408

Title

Owner

Phone

(918) 742-7376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 2

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

• Alen Munson Fuller, M.D.

  • Otolaryngology Physician
  • Tulsa, OK
  • NPI 1164422408
  Medicare reassignment NPD Authorized official
• Sami Rumi Framjee, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Tulsa, OK
  • NPI 1033220629
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891996096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045437",
            "telephone_number": "918-742-7376",
            "fax_number": "918-743-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045437",
            "telephone_number": "918-742-7376",
            "fax_number": "918-743-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA OTOLARYNGOLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "ALEN",
        "authorized_official_middle_name": "MUNSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-742-7376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "7801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Otolaryngology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.