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SOUTH TULSA MEDICAL GROUP LLC NPI 1518998483


NPI Information

NPI: 1518998483
Provider Name: SOUTH TULSA MEDICAL GROUP LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
8803 S 101ST EAST AVE
STE 100
TULSA, OK
ZIP 74133
Phone: (918) 392-5470
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SOUTH TULSA MEDICAL GROUP LLC is an internal medicine in Tulsa, OK. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SOUTH TULSA MEDICAL GROUP LLC NPI is 1518998483. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8803 S 101ST EAST AVE
STE 100
TULSA, OK
ZIP 74133-726
Phone: (918) 392-5470

The provider's authorized official is Debbie Brewer .
The authorized official title is Director Of Provider Enrollment and has the following contact phone number (877) 892-9813.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 9/9/2008.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeNo
2364S00000XClinical Nurse SpecialistNo
3207R00000XInternal MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1300522262MEDICARE PINOKLAHOMA
2200106940AMEDICAIDOKLAHOMA

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

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