Provider Demographics
NPI:1285018713
Name:OB GYN SPECIALISTS OF TULSA PLLC
Entity Type:Organization
Organization Name:OB GYN SPECIALISTS OF TULSA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GENA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-712-8700
Mailing Address - Street 1:1919 S WHEELING AVE
Mailing Address - Street 2:STE. 700
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5638
Mailing Address - Country:US
Mailing Address - Phone:918-712-8700
Mailing Address - Fax:918-984-3490
Practice Address - Street 1:1919 S WHEELING AVE
Practice Address - Street 2:STE. 700
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5638
Practice Address - Country:US
Practice Address - Phone:918-712-8700
Practice Address - Fax:918-984-3490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty