MEDICARE: DR. JAMES RICHARD CULP

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
1	207P00000X	Emergency Medicine Physician	2006010966	MO
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	10871	OK
3	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	GO388	TX

General Provider Information

NPI Number	:	1922149780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES RICHARD CULP

Provider Business Mailing Address
First Line	:	4209 E 72ND PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-6147
Country	:	US
Telephone Number	:	918-292-2199
Fax Number	:	918-292-2183

Provider Business Practice Location Address
First Line	:	3900 N MINGO RD
Second Line	:	MD#4
City	:	TULSA
State	:	OK
Zip	:	74116-5000
Country	:	US
Telephone Number	:	918-292-3972
Fax Number	:	918-292-2183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	10/13/2015

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