Organization · Type 2 NPI

Oklahoma State University

Medical Specialty Clinic/Center · Tulsa, OK

NPI number 1780321893 Active

Practice location

5310 E 31st St Ste 1102
Tulsa, OK 74135-5018

Call (918) 561-1890 Map

Fax (918) 561-1889

Mailing address

5310 E 31st St Fl 13
Tulsa, OK 74135-5018

Specialties and licenses

Taxonomy	Code	License
Medical Specialty Clinic/Center Primary	261QM2500X	None listed

Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Another provider at this address

Megan Kara Deitz, LCSWClinical Social Worker Tulsa, OK NPI 1770716631

Other medical specialty clinic/center providers in Tulsa

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NPI record

NPI: 1780321893
Entity type: Organization (Type 2)
Issued: May 19, 2022
Last updated: Oct 28, 2024
Status: Active
Subpart: Yes of Oklahoma State University

Other names

<unavail>
Osu Physicians · doing business as
Osu Physicians · doing business as
Osu Addiction Medicine · other name

Authorized official

Eric John Polak
VP Administrative Affairs
(918) 561-8422

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780321893

Oklahoma State University's National Provider Identifier is 1780321893, issued on May 19, 2022. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Tulsa, OK. The record was last updated on Oct 28, 2024.