Individual
JUSTIN PUTHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1802 E 19TH ST, TULSA, OK 74104-5403
(918) 634-7539
Mailing address
1802 E 19TH ST, TULSA, OK 74104-5403
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
33927
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
33927
OK
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/17/2018
Last updated
08/12/2021
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