Healthcare Provider Details

I. General information

NPI: 1598708281
Provider Name (Legal Business Name): JOEL CHRISTOPHER NUNLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 S UTICA AVE STE A
TULSA OK
74104
US

IV. Provider business mailing address

1717 S UTICA AVE STE A
TULSA OK
74104-5346
US

V. Phone/Fax

Practice location:
  • Phone: 918-748-7557
  • Fax: 918-403-0383
Mailing address:
  • Phone: 918-748-7557
  • Fax: 918-403-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01063492A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24183
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: