Provider Demographics
NPI:1508541632
Name:OKLAND FACIAL PLASTIC SURGERY, PC
Entity Type:Organization
Organization Name:OKLAND FACIAL PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:S
Authorized Official - Last Name:OKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-583-5974
Mailing Address - Street 1:3900 E MEXICO AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3943
Mailing Address - Country:US
Mailing Address - Phone:720-583-5974
Mailing Address - Fax:720-817-0335
Practice Address - Street 1:3900 E MEXICO AVE STE 501
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3943
Practice Address - Country:US
Practice Address - Phone:720-583-5974
Practice Address - Fax:720-817-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty