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NPI Code Detail

MEDICARE: MR. VINCENT PAUL PEOPLES LCSW

MEDICARE: MR. VINCENT PAUL PEOPLES LCSW
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
11041C0700XClinical Social Worker2958OK

General Provider Information

NPI Number : 1902057110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VINCENT PAUL PEOPLES LCSW
Provider Business Mailing Address
First Line : 7327 S ERIE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-7102
Country : US
Telephone Number : 918-477-7996
Fax Number :
Provider Business Practice Location Address
First Line : 2323 S HARVARD AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-3301
Country : US
Telephone Number : 918-293-2140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2008
Last Update Date : 12/30/2008

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