Provider Demographics
NPI:1891893475
Name:TULSA CITY-COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:TULSA CITY-COUNTY HEALTH DEPARTMENT
Other - Org Name:FAMILY PLANNING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION CHIEF, COMMUNITY HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-594-4822
Mailing Address - Street 1:315 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-2203
Mailing Address - Country:US
Mailing Address - Phone:918-594-4706
Mailing Address - Fax:918-594-4889
Practice Address - Street 1:315 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-2203
Practice Address - Country:US
Practice Address - Phone:918-594-4706
Practice Address - Fax:918-594-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100749470AMedicaid