Healthcare Provider Details

I. General information

NPI: 1760486302
Provider Name (Legal Business Name): HELEN M BUMPUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 E FRANK PHILLIPS SUITE 100
BARTLESVILLE OK
74006-2401
US

IV. Provider business mailing address

226 SE DEBELL BLDG A
BARTLESVILLE OK
74006
US

V. Phone/Fax

Practice location:
  • Phone: 918-338-3777
  • Fax: 918-331-2346
Mailing address:
  • Phone: 918-338-3777
  • Fax: 918-331-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12376
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number12376
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: