Individual
KELLY DUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5310 E 31ST ST FL 11, STE 1102, TULSA, OK 74135-5018
(918) 561-1890
(918) 561-1701
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
30634
OK
2084P0800X
Psychiatry Physician
30634
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200597110A
—
OK
01
—
670528
MEDICARE
OK
Enumeration date
04/08/2014
Last updated
04/20/2022
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