Healthcare Provider Details

I. General information

NPI: 1972947604
Provider Name (Legal Business Name): ROBERT TRENT HULSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W CHEROKEE AVE
ENID OK
73701-5410
US

IV. Provider business mailing address

900 W CHEROKEE AVE
ENID OK
73701-5410
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-6707
  • Fax: 580-233-3724
Mailing address:
  • Phone: 580-233-6707
  • Fax: 580-233-3724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number29954
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: