Individual
CALEB NUNLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12455 E 100TH ST N, STE. 120, OWASSO, OK 74055-4674
(918) 272-9464
(918) 272-9512
Mailing address
12455 E 100TH ST N, STE. 120, OWASSO, OK 74055-4674
(918) 272-9464
(918) 272-9512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25872
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
25872
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002106508
—
OK
Enumeration date
07/05/2007
Last updated
02/10/2017
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