Healthcare Provider Details

I. General information

NPI: 1639349194
Provider Name (Legal Business Name): JAMES P HUTTON MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 S UTICA AVE SUITE 315
TULSA OK
74104-6520
US

IV. Provider business mailing address

PO BOX 21228 DEPT 157
TULSA OK
74121-1228
US

V. Phone/Fax

Practice location:
  • Phone: 405-485-9920
  • Fax: 405-485-9930
Mailing address:
  • Phone: 405-485-9920
  • Fax: 405-485-9930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number14704
License Number StateOK

VIII. Authorized Official

Name: DR. JAMES PHILIP HUTTON
Title or Position: PHYSICIAN
Credential: MD
Phone: 405-485-9920