Provider Demographics
NPI:1487826608
Name:DRS KARLAK AND MARTIN
Entity Type:Organization
Organization Name:DRS KARLAK AND MARTIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-748-7677
Mailing Address - Street 1:1725 E 19TH ST
Mailing Address - Street 2:SUITE 602
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5437
Mailing Address - Country:US
Mailing Address - Phone:918-748-7677
Mailing Address - Fax:918-748-7606
Practice Address - Street 1:1725 E 19TH ST
Practice Address - Street 2:SUITE 602
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5437
Practice Address - Country:US
Practice Address - Phone:918-748-7677
Practice Address - Fax:918-748-7606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14327207R00000X
OK14394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK04444887152Medicaid
OK444488715POtherMEDICARE
OK484622519001OtherBCBS
OK730536372059OtherBCBS
OK00484622519Medicaid
OK048462251TOtherMEDICARE
OK484622519001OtherBCBS
OKD34878Medicare UPIN
OK04444887152Medicaid