Provider Demographics
NPI:1487623401
Name:WOLF, JOSEPH E (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:WOLF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2401 SOUTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-2726
Mailing Address - Country:US
Mailing Address - Phone:918-561-5701
Mailing Address - Fax:918-561-1173
Practice Address - Street 1:4415 S HARVARD AVE STE 125
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-9700
Practice Address - Country:US
Practice Address - Phone:918-748-8111
Practice Address - Fax:918-744-5284
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-05-13
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Provider Licenses
StateLicense IDTaxonomies
OK1308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100055490AMedicaid
OKOKA1011602OtherMEDICARE