Individual
JEREMY SCOTT FULLINGIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4500 S GARNETT RD, TULSA, OK 74146-5229
(918) 599-5031
Mailing address
16155 N 68TH WEST AVE, SKIATOOK, OK 74070-4313
(918) 269-3359
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4186
OK
Other
Enumeration date
06/25/2007
Last updated
03/04/2026
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