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NPI Code Detail

MEDICARE: JOHN N. PUNNI II

MEDICARE: JOHN N. PUNNI II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1487901617
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN N. PUNNI II
Provider Business Mailing Address
First Line : 3 E MAIN ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-2405
Country : US
Telephone Number : 405-639-2080
Fax Number :
Provider Business Practice Location Address
First Line : 3 E MAIN ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-2405
Country : US
Telephone Number : 405-639-2080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2012
Last Update Date : 08/07/2012

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