Provider Demographics
NPI:1558716480
Name:RHEUMATOLOGY & OSTEOPOROSIS INSTITUTE OF OKLAHOMA LLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY & OSTEOPOROSIS INSTITUTE OF OKLAHOMA LLC
Other - Org Name:CENTRAL STATES ORTHOPEDIC SPECIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-481-7644
Mailing Address - Street 1:6585 S YALE AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8384
Mailing Address - Country:US
Mailing Address - Phone:918-388-3999
Mailing Address - Fax:918-502-4750
Practice Address - Street 1:6585 S YALE AVE
Practice Address - Street 2:STE 310
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8384
Practice Address - Country:US
Practice Address - Phone:918-388-3999
Practice Address - Fax:918-502-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty