Provider Demographics
NPI:1558133231
Name:OPTIMUM HEALTH LLC
Entity Type:Organization
Organization Name:OPTIMUM HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROADHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-481-2772
Mailing Address - Street 1:6565 S YALE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8302
Mailing Address - Country:US
Mailing Address - Phone:918-481-2772
Mailing Address - Fax:918-481-2774
Practice Address - Street 1:6565 S YALE AVE STE 106
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8302
Practice Address - Country:US
Practice Address - Phone:918-481-2772
Practice Address - Fax:918-481-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty