OKLAHOMA STATE UNIVERSITY (NPI# 1306882261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306882261 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA STATE UNIVERSITY |
| Other Organization Name | OSU PHYSICIANS |
| Practice Address |
2345 Southwest Blvd Tulsa OK 74107-2705 |
| Mailing Address |
2401 Southwest Blvd Tulsa OK 74107-2726 |
| Practice Telephone | 9185615701 |
| Practice Fax Number | 9185859273 |
| Mailing Telephone | 9185615701 |
| Mailing Fax Number | 9185611173 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2019-12-09 |
| Authorized Official Name | ERIC JOHN POLAK (VP/CFO) |
| Authorized Official Telephone | 9185618422 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100757080A | 05 |
| Other Name | Type Code |
|---|---|
| OSU Health Care Center | Doing Business As Name - Organization |
| OSU Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326495433 | Oklahoma State University | Clinical Medical Laboratory | 1111 W 17th St # A-220, Tulsa, OK 74107-1886 | 2016-05-18 |
| 1679872535 | Oklahoma State University | Community/Behavioral Health | 101 Hes-west, Oklahoma State University, Stillwater, OK 74078-6122 | 2011-03-17 |
| 1104294818 | Oklahoma State University | Clinic/Center | 744 W 9th St, Tulsa, OK 74127-9020 | 2015-09-11 |
| 1063681104 | Oklahoma State University | Physical Therapist | 170 Athletics Center, Stillwater, OK 74078-0001 | 2008-02-22 |
| 1598827776 | Oklahoma State University | Clinic/Center | 1202 W Farm Rd, Stillwater, OK 74078-2036 | 2006-12-14 |
| 1700994878 | Oklahoma State University | Audiologist | 042 Murray, Stillwater, OK 74078 | 2006-08-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OKLAHOMA STATE UNIVERSITY | 401 Whitehurst Hall, Stillwater, OK 74078-1030 |
| System for Award Management (SAM) Entities | OKLAHOMA STATE UNIVERSITY MEDICAL CENTER | 744 W 9th St, Tulsa, OK 74127-9020 |
| Oklahoma Business Registrations | OKLAHOMA STATE UNIVERSITY MEDICAL CENTER TRUST | *********, ** ****** |
| Oklahoma Business Registrations | OKLAHOMA STATE UNIVERSITY MEDICAL TRUST | 744 W 9th St, Tulsa, OK 74127 |
| Street Address |
2345 SOUTHWEST BLVD |
| City | TULSA |
| State | OK |
| Zip Code | 74107-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164403986 | Lana Dawn Myers | Family Medicine | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2005-11-09 |
| 1164040879 | Osu Center for Health Sciences | Clinic/Center | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-07-09 |
| 1962031591 | Dylan Tyler Roberts | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-06 |
| 1265061733 | Emil Amar Kasmia | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-06 |
| 1538798178 | Cody Hume Miller | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-06 |
| 1689203580 | Josiah Thomas Greer | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-03 |
| 1437788452 | Brandon Edward Rawlinson | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-02 |
| 1073142022 | Nicole L Abel | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-02 |
| 1952939183 | Tyler D Ingersoll | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-01 |
| 1144858358 | Christopher Jason Guinn | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508493784 | Squareone Compassion Inc | Clinic/Center | 5323 South 65th West Avenue, Tulsa, OK 74107 | 2020-03-26 |
| 1649772476 | Lauren Michele Rogers | Student in an Organized Health Care Education/Training Program | 1111 W. 17th St., Barson 241, Tulsa, OK 74107 | 2018-03-07 |
| 1336641828 | Frank Patrick Goodman | Student in an Organized Health Care Education/Training Program | 2345 Sw Blvd, Tulsa, OK 74107 | 2018-03-01 |
| 1659827269 | Careatc - America Waste | Clinic/Center | 23322 Southwest Blvd, Tulsa, OK 74107 | 2016-09-01 |
| 1538530886 | Jeremy Michael Bowles | Pharmacist | 4227 Southwest Boulevard, Tulsa, OK 74107 | 2015-10-13 |
| 1760725865 | Nicholas Alexander | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd., Osu Health Care Center, Tulsa, OK 74107 | 2013-03-27 |
| 1295095321 | Robert Steven Wedding | Counselor | 6033 S. 31 St. West Ave., Tulsa, OK 74107 | 2012-05-23 |
| 1295911451 | American Current Care P.a. | Clinic/Center | 5682 W Skelly Drive, Tulsa, OK 74107 | 2008-01-17 |
| 1821200072 | Leeca Jenkins | Counselor | 2007 W. 57th St, Tulsa, OK 74107 | 2007-05-03 |
| 1477670552 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 5682 W. Skelly Drive, Tulsa, OK 74107 | 2007-03-23 |
| Find all providers in zip 74107 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| 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). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922572809 | Endovascular Consulting Solutions | Clinic/Center | 1705 E 19th St Ste 410, Tulsa, OK 74104-5415 | 2019-01-14 |
| 1730584509 | Digital Diagnostic Solutions LLC | Clinic/Center | 5017 S Frontage Road, Tulsa, OK 74107-8976 | 2014-10-23 |
| 1912211475 | Osu Center for Health Sciences | Clinic/Center | 8803 S 101st East Ave Ste 245, Tulsa, OK 74133-5730 | 2010-07-27 |
| 1295059400 | Care Clinic | Clinic/Center | 3528 N Lansing Ave, Tulsa, OK 74106-1939 | 2010-03-16 |
| 1558559468 | Douglas M. Vaughn, D.o., P.C. | Clinic/Center | 4629 S Harvard Ave, Suite A, Tulsa, OK 74135-2948 | 2007-10-05 |
| 1881753358 | State of Oklahoma - Osu Center for Health Sciences College of Osteopat | Clinic/Center | 446 W Latimer St, Tulsa, OK 74106-5106 | 2006-12-08 |
| 1114092012 | Osu Center for Health Sciences | Clinic/Center | 9001 S 101 E Ave, Suite 300, Tulsa, OK 74133 | 2006-11-24 |
| 1225102866 | Osu Center for Health Sciences | Clinic/Center | 4500 S Garnett Rd Ste 919, Tulsa, OK 74146-5229 | 2006-11-17 |
| 1982777637 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 500, Tulsa, OK 74127-9060 | 2006-11-17 |
| 1467526046 | Osu Center for Health Sciences | Clinic/Center | 4444 S Harvard Ave Ste 100, Tulsa, OK 74135-2611 | 2006-11-17 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.