Provider Demographics
NPI:1669016168
Name:MIDTOWN PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:MIDTOWN PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-960-2006
Mailing Address - Street 1:1145 S UTICA AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4015
Mailing Address - Country:US
Mailing Address - Phone:918-960-2006
Mailing Address - Fax:
Practice Address - Street 1:1145 S UTICA AVE STE 403
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4015
Practice Address - Country:US
Practice Address - Phone:918-960-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care