KIDS PEDIATRIC AND ADOLESCENT CARE NPI 1285891945

NPI Information

KIDS PEDIATRIC AND ADOLESCENT CARE is an adolescent medicine pediatrics in Tulsa, OK. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. KIDS PEDIATRIC AND ADOLESCENT CARE NPI is 1285891945. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7711 E 111TH ST
SUITE 111
TULSA, OK
ZIP 74133-570
Phone: (918) 394-5437

The provider's authorized official is John C Knippers .
The authorized official title is Physician/owner and has the following contact phone number (918) 394-5437.

The CLIA number assigned to this NPI record is 37D1095655 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2008 and was last updated on 5/20/2008.

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:

Other Identifiers

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

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