OrganizationActive
Primary Care at Home LLC
NPI 1871148908 · Geriatric Medicine (Family Medicine) Physician · Tulsa, OK
Provider details
- NPI number
- 1871148908
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Larry Montgomery, Practice Manager(918) 346-3094
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
9526 S 86th East Ave
Tulsa, OK 74133-6415
Phone: (918) 346-3094
Approximate (ZIP-level) locationGet directions
Mailing address
9526 S 86th East Ave
Tulsa, OK 74133-6415
Registry dates
- Enumerated
- 2019-08-06
- Last updated
- 2019-08-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.