MEDICARE: MICHAEL L BUMPUS MD

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	207Q00000X	Family Medicine Physician	13096	OK

General Provider Information

NPI Number	:	1932108792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L BUMPUS MD

Provider Business Mailing Address
First Line	:	3450 E FRANK PHILLIPS BLVD
Second Line	:	STE 200
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2401
Country	:	US
Telephone Number	:	918-331-2444
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 E FRANK PHILLIPS BLVD
Second Line	:	SUITE 602
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2495
Country	:	US
Telephone Number	:	918-331-2444
Fax Number	:	918-331-2443

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	09/07/2016

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