NPIMap

Organization Active NPI

Osu Center for Health Sciences

Doing business as Osu-Aj MMG Neurology and Neurosurgery

  • Clinic/Center
  • Lawton, OK
National Provider Identifier
1982239703
Registry record updated Mar 12, 2020
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 MMG Neurology and Neurosurgery
Practice address
3201 W Gore Blvd Ste 300
Lawton, OK 73505-6350
Phone
(918) 561-8306
Fax
(918) 561-5747
NPI assigned
Mar 12, 2020
Last updated
Mar 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Authorized official

Name
Eric John Polak
Title
Vice President for Admin/Finance
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

3201 W Gore Blvd Ste 300
Lawton, OK 73505-6350

Mailing address

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

Other names 1

  • OSU-AJ MMG NEUROLOGY AND NEUROSURGERY Doing business as

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1982239703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SOUTHWEST BLVD",
            "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": "3201 W GORE BLVD STE 300",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056350",
            "telephone_number": "918-561-8306",
            "fax_number": "918-561-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU CENTER FOR HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR ADMIN/FINANCE",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU-AJ MMG NEUROLOGY AND NEUROSURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.