Healthcare Provider Details

I. General information

NPI: 1205840436
Provider Name (Legal Business Name): JAMES D MCKAY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 TERRACE DR
TULSA OK
74104-4626
US

IV. Provider business mailing address

1430 TERRACE DR
TULSA OK
74104-4626
US

V. Phone/Fax

Practice location:
  • Phone: 918-748-8024
  • Fax: 918-748-8249
Mailing address:
  • Phone: 918-748-8024
  • Fax: 918-748-8249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number1948
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: