Pettingell, Timothy

Pettingell, Timothy is an sole proprietor health care provider with primary practice located at 4735 E 91St St Suite 100, Tulsa OK 74137-2807. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Pettingell, Timothy can be contacted via phone (918) 252-7952.

Contact Information

Primary practice address
4735 E 91St St Suite 100 Tulsa OK 74137-2807
Fax: (918) 252-9218
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 20806 Oklahoma

Profile Details

NPI number 1376546531
LBN Legal business name Pettingell, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2005
Last updated May 29th, 2012 - 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 1376546531 NPPES
Oklahoma MEDICAID 100251620A

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