Provider Demographics
NPI:1598838302
Name:OSU CENTER FOR HEALTH SCIENCES
Entity Type:Organization
Organization Name:OSU CENTER FOR HEALTH SCIENCES
Other - Org Name:OSU-AJ BAPTIST REGIONAL ASSOCIATED PHYSICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR CLINIC FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:E
Authorized Official - Last Name:PENICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-561-8322
Mailing Address - Street 1:2345 SOUTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-2705
Mailing Address - Country:US
Mailing Address - Phone:918-561-8306
Mailing Address - Fax:918-561-1173
Practice Address - Street 1:310 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6743
Practice Address - Country:US
Practice Address - Phone:918-540-7712
Practice Address - Fax:918-540-7786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty