Healthcare Provider Details

I. General information

NPI: 1023086378
Provider Name (Legal Business Name): DANIEL J CULKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2006
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST OUPB5400
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

920 STANTON L YOUNG BLVD # WP2140
OKLAHOMA CITY OK
73104-5036
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6452
  • Fax:
Mailing address:
  • Phone: 405-271-6900
  • Fax: 405-271-3118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number19031
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: