Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 5455 | OK |
Y | 111NI0900X | Internist | 5455 | OK |
NPI | 1003178443 |
---|---|
Provider Name | Dr. Kaleb Tanner Veit |
First Address | Tulsa, OK 74127-9023 |
Second Address | Tulsa, OK 74127-9023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 12/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200495750A | (05) | OK |
480147YM2Y | MEDICARE (01) | OK |