Individual
GRACE CHAMPLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4300
Mailing address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39918
OK
208000000X
Pediatrics Physician
56735
TN
208000000X
Pediatrics Physician
MD0000056735
TN
208000000X
Pediatrics Physician
T3052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200851220B
—
OK
Enumeration date
04/11/2016
Last updated
11/19/2024
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