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NPI 1205976404 · Prosthetic/Orthotic Supplier · Tulsa, OK
Provider details
- NPI number
- 1205976404
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Richard Poore, President(918) 622-9447
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4717 S Mingo Rd
Suite C
Tulsa, OK 74146
Phone: (918) 622-9447
Street-level locationGet directions
Mailing address
Po Box 471005
Tulsa, OK 74147-1005
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.