Unknown Individual – Emergency Medicine Physician, NPI 1710163266

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in Tulsa, Oklahoma. specializing in Emergency Medicine Physician. They hold a License No. 3653 (OK). The NPI Number for Unknown Individual is 1710163266

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1710163266

Phone

(918) 587-1101

Address

1007 S PEORIA AVE

Deactivation Date

11 January 2022

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

1007, Peoria Avenue, Skiatook, Tulsa County, Oklahoma, 74073, United States
TULSA, OK 741204495
Phone: (918) 587-1101
Type: Mailing
1501, Southeast 8th Street, Wagoner, Wagoner County, Oklahoma, 74467, United States
WAGONER, OK 744676757
Phone: (918) 485-8400
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74120)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?

In the U.S., Unknown Individual is identified by NPI 1710163266.

Should I call the clinic if Unknown Individual is inactive here?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Tulsa, Oklahoma in registry-derived data.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.