Utica Plastic Surgery Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

12982 Issued in OK

Legal business name

UTICA PLASTIC SURGERY INC

Practice address

1145 S Utica Ave
Suite 1109
Tulsa, OK 74104-4000

Phone

(918) 582-6958

Fax

(918) 582-8155

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Gene Kirk, MD

Title

Owner

Phone

(918) 582-6958

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952527178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 1109",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-582-6958",
            "fax_number": "918-582-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 1109",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-582-6958",
            "fax_number": "918-582-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTICA PLASTIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-582-6958",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OK",
            "license": "12982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUESHIELD",
            "identifier": "444447183001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Utica Services Inc. (Regional Radiology)
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• Utica Women's Specialists, LLC
• Kenley Utley, APRN

• Plastic and Reconstructive Surgery Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Plastic and Reconstructive Surgery 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.