Provider Demographics
NPI:1891282877
Name:PREMIER RHEUMATOLOGY OF OKLAHOMA
Entity Type:Organization
Organization Name:PREMIER RHEUMATOLOGY OF OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADD FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-488-8840
Mailing Address - Street 1:6114 E. 61ST STREET
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-488-8840
Mailing Address - Fax:918-488-8842
Practice Address - Street 1:6114 E. 61ST STREET
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-488-8840
Practice Address - Fax:918-488-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty