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Individual

CARL JOSEPH DEPAULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3360
(918) 458-3511
Mailing address
111 TOMMYE LN, TAHLEQUAH, OK 74464-4173
(918) 458-3360
(918) 458-3511

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
45362-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150664001
AR
05
200012890A
OK
Enumeration date
11/07/2005
Last updated
01/11/2011
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