Healthcare Provider Details

I. General information

NPI: 1922149780
Provider Name (Legal Business Name): DR. JAMES RICHARD CULP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JAMES RICHARD CULP M.D.

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 N MINGO RD MD#4
TULSA OK
74116-5000
US

IV. Provider business mailing address

4209 E 72ND PL
TULSA OK
74136-6147
US

V. Phone/Fax

Practice location:
  • Phone: 918-292-3972
  • Fax: 918-292-2183
Mailing address:
  • Phone: 918-292-2199
  • Fax: 918-292-2183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2006010966
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number10871
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberGO388
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: