AHS OKLAHOMA PHYSICIAN GROUP LLC NPI 1235182775

NPI Information

  • NPI: 1235182775
  • Provider Name: AHS OKLAHOMA PHYSICIAN GROUP LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: UTICA PARK CLINIC
  • CLIA Number: 37D1010290
  • Address: 1145 S UTICA AVE
    SUITE 110
    TULSA, OK
    ZIP 74104
  • Phone: (918) 579-3826

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NPI Details

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 37D1010290 - 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 License Number License State Primary
1207Q00000XFamily MedicineYes
2207R00000XInternal MedicineNo
3207RI0200XInternal MedicineInfectious DiseaseNo
4207T00000XNeurological SurgeryNo
5207X00000XOrthopaedic SurgeryNo
6207Y00000XOtolaryngologyNo
7208000000XPediatricsNo
82080P0006XPediatricsDevelopmental - Behavioral PediatricsNo
92080P0210XPediatricsPediatric NephrologyNo
102081P2900XPhysical Medicine & RehabilitationPain MedicineNo
112084N0400XPsychiatry & NeurologyNeurologyNo
12208600000XSurgeryNo
13208800000XUrologyNo
14363A00000XPhysician AssistantNo
15363L00000XNurse PractitionerNo

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
1200044160AMEDICAIDOKLAHOMA

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: 11/21/2025

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