OKLAHOMA STATE UNIVERSITY NPI 1306882261

NPI Information

  • NPI: 1306882261
  • Provider Name: OKLAHOMA STATE UNIVERSITY
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Doing Business As: OSU PHYSICIANS
  • CLIA Number: 37D2000059
  • Address: 2345 SOUTHWEST BLVD
    TULSA, OK
    ZIP 74107
  • Phone: (918) 561-5701

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NPI Details

OKLAHOMA STATE UNIVERSITY is a medical specialty clinic center in Tulsa, OK. The provider is 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). OKLAHOMA STATE UNIVERSITY NPI is 1306882261. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Osu Physicians.

The provider's business location address is:

2345 SOUTHWEST BLVD
TULSA, OK
ZIP 74107-705
Phone: (918) 561-5701
Fax: (918) 585-9273

The provider's authorized official is Eric John Polak .
The authorized official title is Vp/cfo and has the following contact phone number (918) 561-8422.

The CLIA number assigned to this NPI record is 37D2000059 - other - mobile rural health clnc with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2006 and was last updated on 10/28/2024.

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
1204D00000XNeuromusculoskeletal Medicine & OMMNo
2207P00000XEmergency MedicineNo
3207Q00000XFamily MedicineNo
4207R00000XInternal MedicineNo
5207RC0000XInternal MedicineCardiovascular DiseaseNo
6207RP1001XInternal MedicinePulmonary DiseaseNo
7207V00000XObstetrics & GynecologyNo
8208000000XPediatricsNo
92084A0401XPsychiatry & NeurologyAddiction MedicineNo
102084N0400XPsychiatry & NeurologyNeurologyNo
112084P0800XPsychiatry & NeurologyPsychiatryNo
12208600000XSurgeryNo
13208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
14261QM2500XClinic/CenterMedical SpecialtyYes

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
1100757080AMEDICAIDOKLAHOMA

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: 3/30/2025

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