Pettigrove, Bruce Ben

Pettigrove, Bruce Ben is an sole proprietor health care provider with primary practice located at 6606 S. Yale #220, Tulsa OK 74136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Pettigrove, Bruce Ben can be contacted via phone (918) 492-4122.

Contact Information

Primary practice address
6606 S. Yale #220 Tulsa OK 74136
Phone: (918) 492-4122
Fax: (918) 492-7451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 13121 Oklahoma

Profile Details

NPI number 1154351310
LBN Legal business name Pettigrove, Bruce Ben
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Dec 12th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154351310 NPPES
Oklahoma MEDICAID 200020920 A
Oklahoma MEDICAID 100089490A

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