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NPI Code Detail

MEDICARE: JAMES R SUMNER D.O.

MEDICARE: JAMES R SUMNER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician2555OK

General Provider Information

NPI Number : 1396747168
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES R SUMNER D.O.
Provider Business Mailing Address
First Line : PO BOX 1610
Second Line :
City : DURANT
State : OK
Zip : 74702-1610
Country : US
Telephone Number : 580-924-3400
Fax Number : 580-924-7732
Provider Business Practice Location Address
First Line : 1610 W UNIVERSITY BLVD
Second Line :
City : DURANT
State : OK
Zip : 74701-3045
Country : US
Telephone Number : 580-924-3400
Fax Number : 580-924-7732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 07/08/2007

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