Provider Demographics
NPI:1285727289
Name:STEWART J KATZ MD CARDIOVASCULAR SPECIALISTS INC PC
Entity type:Organization
Organization Name:STEWART J KATZ MD CARDIOVASCULAR SPECIALISTS INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-744-9400
Mailing Address - Street 1:1705 E 19TH ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5405
Mailing Address - Country:US
Mailing Address - Phone:918-744-9400
Mailing Address - Fax:918-744-9416
Practice Address - Street 1:1705 E 19TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5405
Practice Address - Country:US
Practice Address - Phone:918-744-9400
Practice Address - Fax:918-744-9416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200005850AMedicaid
OK800522213Medicare PIN