Provider Demographics
NPI:1780473983
Name:HART, TATUM (DC)
Entity type:Individual
Prefix:DR
First Name:TATUM
Middle Name:
Last Name:HART
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2832 RIDGEWAY CIR
Mailing Address - Street 2:
Mailing Address - City:JONES
Mailing Address - State:OK
Mailing Address - Zip Code:73049-4973
Mailing Address - Country:US
Mailing Address - Phone:405-505-6238
Mailing Address - Fax:
Practice Address - Street 1:924 NW 58TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-5900
Practice Address - Country:US
Practice Address - Phone:405-459-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor