Individual
DR. TIMOTHY WADE HEPNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 E 19TH ST, SUITE 800, TULSA, OK 74104-5472
(918) 301-2505
(918) 744-3633
Mailing address
1725 E 19TH ST, SUITE 800, TULSA, OK 74104-5472
(918) 301-2505
(918) 744-3633
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17478
OK
2086S0127X
Trauma Surgery Physician
17478
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020022913
RAILROAD MEDICARE
OK
05
—
100131540A
—
OK
Enumeration date
06/30/2006
Last updated
03/09/2010
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