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NPI Code Detail

MEDICARE: DR. JOHN D DEWITT DO

MEDICARE: DR. JOHN D DEWITT DO
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
12084N0400XNeurology Physician1512OK

General Provider Information

NPI Number : 1982694048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN D DEWITT DO
Provider Business Mailing Address
First Line : 717 S HOUSTON AVE
Second Line : SUITE 406
City : TULSA
State : OK
Zip : 74127-9023
Country : US
Telephone Number : 918-586-4775
Fax Number : 918-586-4779
Provider Business Practice Location Address
First Line : 717 S HOUSTON AVE
Second Line : SUITE 406
City : TULSA
State : OK
Zip : 74127-9023
Country : US
Telephone Number : 918-586-4775
Fax Number : 918-586-4779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 11/05/2008

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Directions to “ DR. JOHN D DEWITT DO” Practice Location

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