JEREMY SCOTT FULLINGIM


Address: 4500 S Garnett Rd, Tulsa, OK 74146-5229
Phone: 9185995031

JEREMY SCOTT FULLINGIM (NPI# 1255537304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255537304
Entity Type Individual
Full Name JEREMY SCOTT FULLINGIM
Credential D.O.
Practice Address 4500 S Garnett Rd
Tulsa
OK 74146-5229
Mailing Address 12029 S 14th Ct
Jenks
OK 74037-4954
Practice Telephone 9185995031
Mailing Telephone 9182693359
Enumeration Date 2007-06-25
Last Update Date 2012-06-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
4186 OK Allopathic & Osteopathic Physicians

Office Location

Street Address 4500 S GARNETT RD
City TULSA
State OK
Zip Code 74146-5229

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043205453 Jonathan D Friend Anesthesiology 4500 S Garnett Rd, Ste 919, Tulsa, OK 74146-5229 2005-09-13
1326484163 Charles Johnson Radiology Practitioner Assistant 4500 S Garnett Rd, Tulsa, OK 74146-5229 2013-05-20
1821355694 Randy Scott Jordan Radiology Practitioner Assistant 4500 S Garnett Rd, Tulsa, OK 74146-5229 2012-04-18
1528370319 Sindhura Alapati Radiology 4500 S Garnett Rd, Suite 919, Tulsa, OK 74146-5229 2010-07-08
1275776965 Marcus Michael Brown Radiology 4500 S Garnett Rd, 300, Tulsa, OK 74146-5229 2009-04-11
1821233420 Joel Evan Blackwood Radiology Practitioner Assistant 4500 S Garnett Rd, Suite 919, Tulsa, OK 74146-5229 2008-12-10
1053567784 Christos Eugene Vassiliou Radiology 4500 S Garnett Rd, Ste 919, Tulsa, OK 74146-5229 2008-08-13
1588824759 David L Carlston Psychologist 4500 S Garnett Rd, Suite 900, Tulsa, OK 74146-5229 2008-06-11
1518134352 Patrick O'hayre II Radiology 4500 S Garnett Rd, Suite 300, Tulsa, OK 74146-5229 2008-05-12
1043411283 Erich H Muckala Radiology 4500 S Garnett Rd, Ste 300, Tulsa, OK 74146-5229 2007-05-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922624550 Sage Anesthesia Services Inc. Nurse Anesthetist, Certified Registered Union Pines Surgery Center, 4808 S 109th E Ave, Tulsa, OK 74146 2020-06-19
1811401631 Fresenius Medical Care Tulsa, LLC Clinic/Center 5230 S Mingo Rd, Tulsa, OK 74146 2017-12-01
1184158404 Alexis Lauren Allen Case Manager/Care Coordinator 9820 E 41st St #400, Tulsa, OK 74146 2017-04-13
1578995908 Adrian Gheorghe Butuc Massage Therapist 5635 S Mingo #b, Tulsa, OK 74146 2013-08-08
1336587088 Tulsa Cancer Institute, Pllc Obstetrics & Gynecology 12697 E. 51st St. South, Tulsa, OK 74146 2013-06-04
1265782338 Milestones Pediatric Urgent Care Pediatrics 3863 South 103rd E Avenue, Tulsa, OK 74146 2012-09-14
1619232972 Diagnostic Imaging Associates General Acute Care Hospital 4500 S Garnett Rd, Ste 300, Tulsa, OK 74146 2012-07-11
1790046654 Aundra Lamar Fuller Behavioral Analyst 10922 E. 39th St., Tulsa, OK 74146 2012-06-06
1134492416 Mark S Thomas Jr. Behavioral Analyst 10005 E 52nd Street, Tulsa, OK 74146 2012-02-16
1922307958 Founders Healthcare, LLC Durable Medical Equipment & Medical Supplies 5115 S. 122nd East Ave., Suite 204, Tulsa, OK 74146 2011-03-16
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104442292 Direct Medical Imaging LLC Radiology 5711 E 71st St Ste 100, Tulsa, OK 74136-6655 2020-06-24
1386933737 Robert A Skib Md Pllc Radiology 305 S Kenosha Ave, Tulsa, OK 74120-2430 2011-04-06
1639302060 Stephen Arthur Back Radiology 744 W. 9th St., Tulsa, OK 74127 2009-09-02
1427243641 American Radiology Consultants Pllc Radiology 10537 S 92nd East Circle, Tulsa, OK 74133 2007-09-11
1215136361 Colby James Coulson Radiology 7718 E 91st St Ste 220, Tulsa, OK 74133-6064 2007-07-17
1083738199 Us Radiology Partners of Texas Inc Radiology 6129 S Louisville Ave, Tulsa, OK 74136-1502 2007-03-16
1841321668 George Kamp Radiology 6422 S. Indianapolis Place, Tulsa, OK 74136-1421 2007-03-07
1326107624 James R Webb Jr Md PC Radiology 6550 E. 71st Street, Suite 200, Tulsa, OK 74133-2773 2006-12-06
1972675817 Richard Bliss Williams Radiology 2608 E 74th St, Tulsa, OK 74136-5557 2006-11-15
1669405023 John Edward Kauth Radiology 2448 E Admiral Blvd, Tulsa, OK 74110-5323 2006-07-09
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City TULSA
Zip Code 74146

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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