OSU MEDICAL GROUP RIVERSIDE PRIMARY CARE
NPI 1720417546
Clinic/Center in Tulsa, OK

Active since November 02, 2013
9645 RIVERSIDE PKWY, SUITE C, TULSA, OK 74137(918) 561-8306 Get Directions Write a Review

NPPES record last updated: November 2, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Osu Medical Group Riverside Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OSU MEDICAL GROUP RIVERSIDE PRIMARY CARE (NPI 1720417546) is a healthcare organization registered as a clinic/center in Tulsa, Oklahoma and active in the NPI registry since November 2013. The organization lists Eric Polak, Cfo, as its authorized official.

NPPES Registry Identity

NPI1720417546
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameOSU MC PROFESSIONAL SERVICES LLC
Location Address9645 RIVERSIDE PKWY, SUITE CTulsa, OK 74137-7423
Mailing Address2345 Southwest BlvdTulsa, OK 74107-2705 · (918) 561-8306
Organization SubpartNo
Authorized OfficialEric PolakCfo · (918) 561-8422
Enumeration DateNovember 2, 2013
NPI 1720417546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

9645 RIVERSIDE PKWY, Tulsa, OK 74137

Other Names 1

Doing Business AsOsu Medical Group Riverside Primary Care

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine (Sports Medicine)
9645 RIVERSIDE PKWY, SUITE C
TULSA, OK 74137
Nurse Practitioner
9645 RIVERSIDE PKWY, STE C
TULSA, OK 74137

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Osu Mc Professional Services LLC's NPI number?

The NPI number for Osu Mc Professional Services LLC is 1720417546. It was assigned to this organization in the NPPES registry on November 2, 2013. The provider is doing business as Osu Medical Group Riverside Primary Care.

Where is Osu Mc Professional Services LLC located?

Osu Mc Professional Services LLC is located at 9645 Riverside Pkwy Suite C, Tulsa, OK 74137. The listed phone number is (918) 561-8306.

What is Osu Mc Professional Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Osu Mc Professional Services LLC was last updated on November 2, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.