Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 22256 | OK |
NPI | 1023072261 |
---|---|
Provider Name | Dr. Jeffrey C Cumming |
First Address | Ardmore, OK 73401-1206 |
Second Address | Ardmore, OK 73401-1206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 01/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200067020A | (05) | OK |
I44653 | (02) | OK |
P00257715 | RAILROAD MEDICARE (01) | OK |