Provider Demographics
NPI:1871032094
Name:UNIVERSITY OF TULSA ALEXANDER HEALTH CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF TULSA ALEXANDER HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BEAIR BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-631-2241
Mailing Address - Street 1:800 S TUCKER DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-9700
Mailing Address - Country:US
Mailing Address - Phone:918-631-2241
Mailing Address - Fax:
Practice Address - Street 1:800 S TUCKER DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-9700
Practice Address - Country:US
Practice Address - Phone:918-631-2241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5195207R00000X, 208000000X
OK2767363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty