Provider Demographics
NPI:1477194488
Name:ADHD AND MOOD CENTER OF OKLAHOMA
Entity Type:Organization
Organization Name:ADHD AND MOOD CENTER OF OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SPEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-491-5767
Mailing Address - Street 1:6565 SOUTH YALE AVE, SUITE 706
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-491-5767
Mailing Address - Fax:918-491-5771
Practice Address - Street 1:6565 SOUTH YALE AVE, SUITE 706
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-491-5767
Practice Address - Fax:918-491-5771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center