Individual
DR. TIMOTHY PETTINGELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4735 E 91ST ST, SUITE 100, TULSA, OK 74137-2807
(918) 252-7952
(918) 252-9218
Mailing address
10026 S MINGO RD STE A, PMB 234, TULSA, OK 74133-5717
(918) 252-7952
(918) 252-9218
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
20806
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251620A
—
OK
Enumeration date
05/23/2005
Last updated
05/29/2012
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