Organization

South Tulsa Pediatrics Pllj

Pediatrics Physician in Tulsa, OK(View on Map)

Legal Business Name

South Tulsa Pediatrics Pllj

NPI Number

1215920293

NPI Type

Organization

Enumeration Date

08/25/2005

Specialties

(Taxonomies)

Code

208000000X

Primary Taxonomy

Yes

Licenses

State

Oklahoma

License Number

2732

Contact
Information

Purpose

Mailing
Location

Address

7512 E 91ST ST
7512 E 91ST ST

City

Tulsa
Tulsa

State

OK
OK

Postal Code

74133-6050
74133-6050

Country

US
US

Telephone Number

(918) 728-2000
(918) 728-2000

Authorized Official

Name

Dawn Mayberry

Title or Position

OWNER/PHYSICIAN

Telephone Number

(918) 728-2888

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

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