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1922018464
POLY TAN
TULSA, OK
NPI
1922018464
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: OK 20986)
Enumeration Date
2006-08-08
Last Update Date
2007-07-09
Business Address
Dr. POLY TAN M.D.
1620 E 12TH ST
TULSA, OK 74120-5407
Phone number: 918-582-2131
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Mailing Address
Dr. POLY TAN M.D.
7422 W 40TH ST
TULSA, OK 74107-4853
Phone number: 918-447-0495
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