Wackowski, Michael

Wackowski, Michael is an individual health care provider with primary practice located at 6161 S Yale Ave , Tulsa OK 74136-1902. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Wackowski, Michael can be contacted via phone (918) 502-1900.

Contact Information

Primary practice address
6161 S Yale Ave Tulsa OK 74136-1902
Phone: (918) 502-1900
Fax: (918) 494-6303
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 18451 Oklahoma
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 18451 Oklahoma

Profile Details

NPI number 1275592354
LBN Legal business name Wackowski, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Dec 10th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275592354 NPPES
Oklahoma MEDICAID 100020120A

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