=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558645184
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID ROSS RUMPH JR
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2011
-----------------------------------------------------
Last Update Date | 09/30/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3400 E FRANK PHILLIPS BLVD SUITE 400
-----------------------------------------------------
City | BARTLESVILLE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74006-2495
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-331-2533
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 226 SE DEBELL AVE BLDG A
-----------------------------------------------------
City | BARTLESVILLE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74006-2343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-331-2533
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | DAVID R RUMPH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 918-331-2533
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 15648
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------