Provider Demographics
NPI:1821065616
Name:VOSS, HAROLD MATTHEW JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:MATTHEW
Last Name:VOSS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9728 S KNOXVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5250
Mailing Address - Country:US
Mailing Address - Phone:918-298-8677
Mailing Address - Fax:
Practice Address - Street 1:9728 S KNOXVILLE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-5250
Practice Address - Country:US
Practice Address - Phone:918-298-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15662207L00000X
TXM4624207L00000X
LA017365207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100085040BMedicaid
OKOK402277Medicare PIN
OKP00350144Medicare PIN
OK100085040BMedicaid