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NPI Code Detail

MEDICARE: DR. JEFFREY LAWRENCE CUNNINGHAM M.D.

MEDICARE:  DR. JEFFREY LAWRENCE CUNNINGHAM  M.D.
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
1207QS0010XSports Medicine (Family Medicine) Physician30836OK
2207Q00000XFamily Medicine Physician30836OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528300811
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY LAWRENCE CUNNINGHAM M.D.
Provider Business Mailing Address
First Line : 2488 E 81ST ST STE 290
Second Line :
City : TULSA
State : OK
Zip : 74137-4299
Country : US
Telephone Number : 918-927-3226
Fax Number : 918-927-3193
Provider Business Practice Location Address
First Line : 2488 E 81ST ST STE 290
Second Line :
City : TULSA
State : OK
Zip : 74137-4299
Country : US
Telephone Number : 918-494-2665
Fax Number : 918-927-3201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 01/11/2026

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Directions to “ DR. JEFFREY LAWRENCE CUNNINGHAM M.D.” Practice Location

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