UTICA PLASTIC SURGERY INC (NPI# 1952527178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952527178 |
| Entity Type | Organization |
| Organization Name | UTICA PLASTIC SURGERY INC |
| Practice Address |
1145 S Utica Ave Suite 1109 Tulsa OK 74104-4000 |
| Practice Telephone | 9185826958 |
| Practice Fax Number | 9185828155 |
| Mailing Telephone | 9185826958 |
| Mailing Fax Number | 9185828155 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT GENE KIRK (OWNER) |
| Authorized Official Telephone | 9185826958 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
12982 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BLUECROSS & BLUESHIELD | 444447183001 | 01 |
| Street Address |
1145 S UTICA AVE SUITE 1109 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133024 | Michael Opong-kusi | Family Medicine | 1145 S Utica Ave, Suite 460, Tulsa, OK 74104-4000 | 2005-09-08 |
| 1639631690 | Gautami Gandham | Student in an Organized Health Care Education/Training Program | 1145 S Utica Ave, Tulsa, OK 74104-4000 | 2019-04-01 |
| 1265948269 | Linda Ellard | Nurse Practitioner | 1145 S Utica Ave, Ste 460, Tulsa, OK 74104-4041 | 2017-12-28 |
| 1972038602 | Laquichesha Trotter | Nurse Practitioner | 1145 S Utica Ave, Suite 364, Tulsa, OK 74104-4000 | 2017-05-01 |
| 1265966980 | Jubin Sadeghian | Student in an Organized Health Care Education/Training Program | 1145 S Utica Ave, Tulsa, OK 74104-4000 | 2017-04-19 |
| 1881128775 | Jacqueline R Froese | Nurse Practitioner | 1145 S Utica Ave, Ste 110, Tulsa, OK 74104-4000 | 2017-04-18 |
| 1861931891 | Brittany Goodin | Nurse Practitioner | 1145 S Utica Ave, Ste 460, Tulsa, OK 74104-4000 | 2017-02-23 |
| 1447796545 | Haresh K Ajmera Md Inc | Specialist | 1145 S Utica Ave, Suite 500, Tulsa, OK 74104-4014 | 2017-01-12 |
| 1396281937 | Chih-ying Lee | Physician Assistant | 1145 S Utica Ave, Suite 460, Tulsa, OK 74104-4000 | 2017-01-06 |
| 1023562204 | Katie Rodgers | Nurse Practitioner | 1145 S Utica Ave, Ste 460, Tulsa, OK 74104-4000 | 2016-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390963 | Kreitzberg Plastic Surgery LLC | Surgery | 6585 S Yale Ave Ste 315, Tulsa, OK 74136-8316 | 2020-06-12 |
| 1346476579 | Brenda Schiesel | Surgery | 10131 S Yale Ave Ste B, Tulsa, OK 74137-6007 | 2009-06-02 |
| 1568479384 | Stephen Murray Paulsen | Surgery | 6585 S Yale Ave Ste 1020, Tulsa, OK 74136-8323 | 2006-08-02 |
| 1770512097 | Greg Ratliff | Surgery | 2107 E 15th St, Tulsa, OK 74104-4613 | 2006-06-30 |
| 1578548475 | Joey M Manduano | Surgery | 2219 E 21st St, Tulsa, OK 74114-1411 | 2005-12-13 |
| 1114923794 | Laurie Ann Duckett | Surgery | 1809 E 13th St Ste 400, Tulsa, OK 74104-4431 | 2005-06-28 |
| 1629365085 | E Bradley Garber, M.d., P.C. | Surgery | 1784 S Utica Ave, Tulsa, OK 74104-5336 | 2011-07-06 |
| 1164651394 | Aesthetic Surgery of Tulsa, Pllc | Surgery | 6802 S Olympia Ave, Suite G113, Tulsa, OK 74132-1823 | 2009-07-09 |
| 1336388792 | Angie M Hignite | Surgery | 2000 S Wheeling Ave Ste 100, Tulsa, OK 74104 | 2009-02-09 |
| 1760644637 | Rola E Eid | Surgery | 6585 S Yale Ave, Suite 315, Tulsa, OK 74136-8384 | 2008-07-01 |
| 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.