Mark Street, MD
Internal Medicine in Tulsa, OK. Individual provider (NPI-1).
NPI number1982165361
StatusActive
Last updated in NPPESJun 24, 2022
Details
- NPI
- 1982165361
- Entity type
- Individual (NPI-1)
- Name
- Mark Street
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2019
- Certification date
- Jun 24, 2022
- Last updated
- Jun 24, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 34812 | OK | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 34812 | OK |
Practice location
1245 S Utica Ave Ste 301Tulsa, OK 74104-4214
Phone 918-382-2536 · Fax 918-382-2576
Mailing address
1245 S Utica Ave Ste 301Tulsa, OK 74104-4214
Phone 918-382-2536 · Fax 918-382-2576
Other practice locations
4502 E 41st St
Tulsa, OK 74135-2536
Tulsa, OK 74135-2536
Phone 918-619-4400
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