DR. JOEY M MANDUANO (NPI# 1578548475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578548475 |
| Entity Type | Individual |
| Full Name | DR. JOEY M MANDUANO |
| Credential | D.O. |
| Practice Address |
2219 E 21st St Tulsa OK 74114-1411 |
| Practice Telephone | 9187495522 |
| Practice Fax Number | 9187475522 |
| Mailing Telephone | 9187495522 |
| Mailing Fax Number | 9187475522 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
1628 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BCBS OF OKLAHOMA | 731047122001 | 01 |
| Street Address |
2219 E 21ST ST |
| City | TULSA |
| State | OK |
| Zip Code | 74114-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356865307 | Helen Marie Collier | Registered Nurse | 2325 S. Harvard Avenue, Tulsa, OK 74114 | 2017-08-01 |
| 1730635640 | Portia Resnick | Specialist/Technologist | 5707 E 24th Pl, Tulsa, OK 74114 | 2016-08-31 |
| 1093177925 | Ana Achlosser | Counselor | 2120 S Jamestown Ave, Tulsa, OK 74114 | 2016-03-21 |
| 1437558277 | Nicole Holzkamper | Case Manager/Care Coordinator | 2525 S Harvard Ave, Tulsa, OK 74114 | 2014-08-18 |
| 1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
| 1598001414 | Zachary Paschall | Counselor | 2325 S Havard Ave, Tulsa, OK 74114 | 2012-12-20 |
| 1346511334 | Chelsea Lee Joslin | Counselor | 2140 S Harvard Ave Ste 200, Tulsa, OK 74114 | 2012-01-23 |
| 1073893210 | Elizabeth C Canfield | Speech-Language Pathologist | 1929 South 74th East Avenue, Tulsa, OK 74114 | 2011-08-19 |
| 1508185430 | Karly Lynn Mason | Social Worker | 2140 S. Harvard, Tulsa, OK 74114 | 2010-05-17 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| Find all providers in zip 74114 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390963 | Kreitzberg Plastic Surgery LLC | Surgery | 6585 S Yale Ave Ste 315, Tulsa, OK 74136-8316 | 2020-06-12 |
| 1346476579 | Brenda Schiesel | Surgery | 10131 S Yale Ave Ste B, Tulsa, OK 74137-6007 | 2009-06-02 |
| 1568479384 | Stephen Murray Paulsen | Surgery | 6585 S Yale Ave Ste 1020, Tulsa, OK 74136-8323 | 2006-08-02 |
| 1770512097 | Greg Ratliff | Surgery | 2107 E 15th St, Tulsa, OK 74104-4613 | 2006-06-30 |
| 1114923794 | Laurie Ann Duckett | Surgery | 1809 E 13th St Ste 400, Tulsa, OK 74104-4431 | 2005-06-28 |
| 1629365085 | E Bradley Garber, M.d., P.C. | Surgery | 1784 S Utica Ave, Tulsa, OK 74104-5336 | 2011-07-06 |
| 1164651394 | Aesthetic Surgery of Tulsa, Pllc | Surgery | 6802 S Olympia Ave, Suite G113, Tulsa, OK 74132-1823 | 2009-07-09 |
| 1336388792 | Angie M Hignite | Surgery | 2000 S Wheeling Ave Ste 100, Tulsa, OK 74104 | 2009-02-09 |
| 1760644637 | Rola E Eid | Surgery | 6585 S Yale Ave, Suite 315, Tulsa, OK 74136-8384 | 2008-07-01 |
| 1952527178 | Utica Plastic Surgery Inc | Surgery | 1145 S Utica Ave, Suite 1109, Tulsa, OK 74104-4000 | 2007-04-17 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.