Healthcare Provider Details

I. General information

NPI: 1457503732
Provider Name (Legal Business Name): JULIE ANNA TUCKER-BARTON RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 10/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MORRIS DR
OKMULGEE OK
74447-6429
US

IV. Provider business mailing address

1558 E 49TH ST
TULSA OK
74105-4806
US

V. Phone/Fax

Practice location:
  • Phone: 918-758-3029
  • Fax: 918-758-3032
Mailing address:
  • Phone: 918-978-0229
  • Fax: 918-758-3032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2974
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: