Provider Demographics
NPI:1225418395
Name:UNIVERSITY OF TULSA
Entity Type:Organization
Organization Name:UNIVERSITY OF TULSA
Other - Org Name:COLLEGE OF HEALTH SCIENCES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FISCAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-631-2617
Mailing Address - Street 1:800 S TUCKER DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-9700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 S BOULDER AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-2827
Practice Address - Country:US
Practice Address - Phone:918-631-2617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty