Healthcare Provider Details

I. General information

NPI: 1033647672
Provider Name (Legal Business Name): CHRISTOPHER RAY WHIPKEY CM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 05/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9726 E 42ND ST STE 124
TULSA OK
74146-3673
US

IV. Provider business mailing address

10720 S 4120 RD
OOLOGAH OK
74053-6352
US

V. Phone/Fax

Practice location:
  • Phone: 405-919-8781
  • Fax:
Mailing address:
  • Phone: 918-906-9494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: