Clark Jiro Tingleaf M.D.

NPI 1881624153 - Urology - 208800000X

NPI Details
NPI 1881624153
Gender Male
Enumeration Date 07/03/2006
Last Updated 05/06/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
10512 N 110TH EAST AVE
STE 200
OWASSO OK, 74055-6636, US
Phone (918) 376-8926
Fax (918) 377-8936
Business Location
10512 N 110TH EAST AVE
STE 200
OWASSO OK, 74055-6636, US
Phone (918) 376-8926
Fax (918) 377-8936
Toxanomy
Taxonomy Code 208800000X
License State Oklahoma
License Number 23509
Remove 1881624153 NPI Number
 

According to our database, Dr. Clark Jiro Tingleaf M.D. NPI is 1881624153, taxonomy code is 208800000X and license number is 23509, license state is located at Oklahoma. Clark Jiro Tingleaf M.D. physically located at 10512 N 110th East Ave, Owasso OK, 74055-6636. NPI Number Clark Jiro Tingleaf M.D. has the Individual type.

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1881624153 NPI number is provided on an as is basis without warranty of any kind. 1881624153 is maintained by the National Plan & Provider Enumeration System. The contents of Clark Jiro Tingleaf M.D. are for informational purposes only.