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General NPI Number Information
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NPI Number | 1780759597
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Entity Type | Organization
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Legal Business Name | ROD PURDIE M D P C
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 3222 E 93RD ST
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City | TULSA
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State | OK
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Zip | 74137-3639
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Country | US
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Telephone | 918-518-5332
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Fax |
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Provider Business Mailing Address
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Address Line | 3222 EAST 93RD ST.
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City | TULSA
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State | OK
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Zip | 74137
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Country | US
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Telephone | 918-518-5332
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROD N PURDIE
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Credential | M.D.
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Telephone | 918-518-5332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 19098
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License Number State | OK
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