Provider Demographics
NPI:1669662672
Name:INFECTIOUS DISEASE AND PAIN MANAGEMENT OF TULSA
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE AND PAIN MANAGEMENT OF TULSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-392-3322
Mailing Address - Street 1:1502 S BOULDER AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4037
Mailing Address - Country:US
Mailing Address - Phone:918-392-3322
Mailing Address - Fax:918-392-3323
Practice Address - Street 1:1502 S BOULDER AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4037
Practice Address - Country:US
Practice Address - Phone:918-392-3322
Practice Address - Fax:918-392-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty