ADVANCED ORTHOPEDICS OF OKLAHOMA PLLC

Provider Demographics

• NPI: 1235676453
• Name: ADVANCED ORTHOPEDICS OF OKLAHOMA PLLC
• Entity Type: Organization
• Organization Name: ADVANCED ORTHOPEDICS OF OKLAHOMA PLLC
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: JOHNATHON
• Authorized Official - Middle Name: JAMES
• Authorized Official - Last Name: OZTURK
• Authorized Official - Phone: 918-927-3214
• Mailing Address - Street 1: 2488 E 81ST ST STE 290
• Mailing Address - City: TULSA
• Mailing Address - State: OK
• Mailing Address - Zip Code: 74137-4265
• Mailing Address - Country: US
• Mailing Address - Phone: 918-494-2665
• Mailing Address - Fax: 918-927-3193
• Practice Address - Street 1: 2488 E 81ST ST STE 290
• Practice Address - City: TULSA
• Practice Address - State: OK
• Practice Address - Zip Code: 74137-4265
• Practice Address - Country: US
• Practice Address - Phone: 918-494-2665
• Practice Address - Fax: 918-927-3201
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2017-01-25
• Last Update Date: 2024-03-06

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Multi-Specialty
No	207QS0010X	Allopathic & Osteopathic Physicians	Family Medicine	Sports Medicine	Group - Multi-Specialty
No	207XX0005X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Sports Medicine	Group - Multi-Specialty
No	208100000X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation		Group - Multi-Specialty
No	2081P2900X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation	Pain Medicine	Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Multi-Specialty
No	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
OK	200712390A	Medicaid
OK	200712390L	Medicaid
OK	200712390O	Medicaid
OK	200712390R	Medicaid
OK	200712390T	Medicaid
OK	200712390E	Medicaid
OK	200712390G	Medicaid
OK	200712390J	Medicaid
OK	200712390I	Medicaid
OK	200712390M	Medicaid
OK	200712390S	Medicaid
OK	200712390B	Medicaid
OK	200712390K	Medicaid
OK	200712390N	Medicaid
OK	200712390H	Medicaid
OK	200712390P	Medicaid
OK	200712390Q	Medicaid