Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northside Family Practice PLLC

Organization Internal Medicine Physician · NPI 1205103231

Northside Family Practice PLLC is an Internal Medicine Physician in Tulsa, Oklahoma. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3606 N Martin Luther King Jr Blvd
Tulsa, OK 74106-6447
Phone: (918) 794-3536
Fax: (918) 794-7784
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1205103231
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Prakash George — Cfo · (918) 704-9408
NPI enumeratedNovember 18, 2011
Last updated in NPPESFebruary 24, 2025
Certification dateFebruary 24, 2025
Mailing address3606 N Martin Luther King Jr Blvd, Tulsa, OK 74106-6447

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