Provider Demographics
NPI:1487645800
Name:WEBB, JAMES ROBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:WEBB
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6550 E 71ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2773
Mailing Address - Country:US
Mailing Address - Phone:918-260-9322
Mailing Address - Fax:918-794-8702
Practice Address - Street 1:6550 E 71ST STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-2754
Practice Address - Country:US
Practice Address - Phone:918-260-9322
Practice Address - Fax:918-794-8702
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK218712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100845730AMedicaid
OK249705802Medicare PIN
OK100845730AMedicaid
OKH73018Medicare UPIN
OKP00232086Medicare PIN