Healthcare Provider Details

I. General information

NPI: 1033192703
Provider Name (Legal Business Name): MARILYN KAY CULP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2005
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 S MINGO RD STE 200
TULSA OK
74133-5722
US

IV. Provider business mailing address

1145 S UTICA AVE STE 110
TULSA OK
74104-4013
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax: 918-592-1021
Mailing address:
  • Phone: 918-579-2981
  • Fax: 918-579-1262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number19097
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: