Basic Information
Provider Information
NPI: 1457677023
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCOTT
FirstName: MICHAEL
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6600 S YALE AVE STE 1200
Address2:  
City: TULSA
State: OK
PostalCode: 741363361
CountryCode: US
TelephoneNumber: 9184886687
FaxNumber:  
Practice Location
Address1: 6161 S YALE AVE
Address2:  
City: TULSA
State: OK
PostalCode: 741361902
CountryCode: US
TelephoneNumber: 9185021900
FaxNumber: 9184946303
Other Information
ProviderEnumerationDate: 04/08/2010
LastUpdateDate: 10/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X6251OKY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


Home