Provider Demographics
NPI:1922149780
Name:CULP, JAMES RICHARD
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:CULP
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:RICHARD
Other - Last Name:CULP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4209 E 72ND PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6147
Mailing Address - Country:US
Mailing Address - Phone:918-292-2199
Mailing Address - Fax:918-292-2183
Practice Address - Street 1:3900 N MINGO RD
Practice Address - Street 2:MD#4
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74116-5000
Practice Address - Country:US
Practice Address - Phone:918-292-3972
Practice Address - Fax:918-292-2183
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006010966207P00000X
OK108712083P0500X
TXGO3882083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD38728Medicare UPIN