Individual
AMY CLAIRE BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6585 S YALE AVE, SUITE 1200, TULSA, OK 74136-8384
(918) 494-9288
(918) 494-9191
Mailing address
6585 S YALE AVE, SUITE 1200, TULSA, OK 74136-8384
(918) 494-9288
(918) 494-9191
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
24281
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200054560A
—
OK
01
—
450778109
TRICARE
OK
Enumeration date
07/21/2005
Last updated
01/14/2008
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