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NPI Profile for SOUTH TULSA RETINA in TULSA, OK.
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Retina Specialist |
207WX0107X | 18 | Physician/Ophthalmology | |
Cornea and External Diseases Specialist |
207WX0120X | 18 | Physician/Ophthalmology | |
Ophthalmology |
207W00000X | 18 | Physician/Ophthalmology | |
Optometrist |
152W00000X | 41 | Optometry |
| NPI # | 1699236307 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/26/2019 | |
| Last updated | 11/27/2023 - About 3 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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SOUTH TULSA RETINA
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SOUTH TULSA RETINA