Healthcare Provider Details

I. General information

NPI: 1366709354
Provider Name (Legal Business Name): LINDSAY CUNNINGHAM D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 07/27/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2622 E 21ST ST STE 1
TULSA OK
74114-1738
US

IV. Provider business mailing address

2622 E 21ST ST STE 1
TULSA OK
74114-1738
US

V. Phone/Fax

Practice location:
  • Phone: 918-935-2775
  • Fax: 539-867-1681
Mailing address:
  • Phone: 918-935-2775
  • Fax: 539-867-1681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number5417
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: