Individual
JOYCE LOUISE BUMGARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 E DEWEY AVE, SAPULPA, OK 74066-4201
(918) 227-2016
Mailing address
7919 S JOPLIN AVE, TULSA, OK 74136-9120
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
13094
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100135370B
—
OK
05
—
100135370C
—
OK
Enumeration date
12/11/2006
Last updated
07/08/2007
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