AHS OKLAHOMA PHYSICIAN GROUP LLC NPI 1235182775

NPI Information

NPI: 1235182775
Provider Name: AHS OKLAHOMA PHYSICIAN GROUP LLC

Doing Business As: UTICA PARK CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

Address:
1145 S UTICA AVE
SUITE 110
TULSA, OK
ZIP 74104
Phone: (918) 579-3826
Get Directions

AHS OKLAHOMA PHYSICIAN GROUP LLC is a family medicine in Tulsa, OK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. AHS OKLAHOMA PHYSICIAN GROUP LLC NPI is 1235182775. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Utica Park Clinic.

The provider's business location address is:

1145 S UTICA AVE
SUITE 110
TULSA, OK
ZIP 74104-000
Phone: (918) 579-3826
Fax: (918) 579-1262

The provider's authorized official is Brandon Mudd .
The authorized official title is Chief Financial Officer and has the following contact phone number (918) 579-1841.

The CLIA number assigned to this NPI record is 37D0991531 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 12/2/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207Q00000X	Family Medicine		Yes
2	207R00000X	Internal Medicine		No
3	207RI0200X	Internal Medicine	Infectious Disease	No
4	207T00000X	Neurological Surgery		No
5	207X00000X	Orthopaedic Surgery		No
6	207Y00000X	Otolaryngology		No
7	208000000X	Pediatrics		No
8	2080P0006X	Pediatrics	Developmental - Behavioral Pediatrics	No
9	2080P0210X	Pediatrics	Pediatric Nephrology	No
10	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine	No
11	2084N0400X	Psychiatry & Neurology	Neurology	No
12	208600000X	Surgery		No
13	208800000X	Urology		No
14	363A00000X	Physician Assistant		No
15	363L00000X	Nurse Practitioner		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200044160A	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »