Provider Demographics
NPI:1538133640
Name:PLUMLEE, GEOFFREY B (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:B
Last Name:PLUMLEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 S 101ST EAST AVE
Mailing Address - Street 2:STE 270
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9001 S 101ST EAST AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5708
Practice Address - Country:US
Practice Address - Phone:918-392-7000
Practice Address - Fax:918-392-7013
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-25370OtherLICENSE #
KS100184820DMedicaid
KSF61074Medicare UPIN
KS100184820DMedicaid