Provider Demographics
NPI:1437802998
Name:TULSA RHEUMATOLOGY CLINIC LLC
Entity Type:Organization
Organization Name:TULSA RHEUMATOLOGY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-935-2775
Mailing Address - Street 1:PO BOX 721602
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-8231
Mailing Address - Country:US
Mailing Address - Phone:918-935-2775
Mailing Address - Fax:539-867-1681
Practice Address - Street 1:2622 E 21ST ST STE 1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1738
Practice Address - Country:US
Practice Address - Phone:918-935-2775
Practice Address - Fax:539-867-1681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty