TULSA PEDIATRIC AND ADOLESCENT MEDICINE PC NPI 1215975883

NPI Information

  • NPI: 1215975883
  • Provider Name: TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Address: 1919 S WHEELING AVE
    SUITE 304
    TULSA, OK
    ZIP 74104
  • Phone: (918) 748-7620

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NPI Details

TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC is a pediatrics in Tulsa, OK. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC NPI is 1215975883. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1919 S WHEELING AVE
SUITE 304
TULSA, OK
ZIP 74104-638
Phone: (918) 748-7620
Fax: (918) 748-7647

The provider's authorized official is Joel K Gist .
The authorized official title is President and has the following contact phone number (918) 748-7620.

The enumeration date for this NPI number is 6/3/2006 and was last updated on 8/22/2020.

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 License Number License State Primary
1208000000XPediatricsYes

What is NPI?

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This page was last updated on: 11/21/2025

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