Northside Family Practice Pllc

NPI #1205103231 in Tulsa, Oklahoma

Provider Information

NPI Number: 1205103231
Entity Type: Organization
Organization Name: Northside Family Practice Pllc
Primary Specialty: Internal Medicine
Enumeration Date: Nov 18, 2011
Last Updated: Feb 24, 2025

Practice Location

Address: 3606 N MARTIN LUTHER KING JR BLVD
City: Tulsa
State: Oklahoma
ZIP Code: 74106-6447
Phone: (918) 794-3536

Authorized Official

Name: PRAKASH GEORGE
Title: CFO
Phone: (918) 704-9408

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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