Individual
JAMES DULL RUTTER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 E 13TH ST, SUITE 101, GROVE, OK 74344-2976
(918) 786-9900
(918) 786-9904
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(918) 786-9900
(918) 786-9904
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21574
OK
208000000X
Pediatrics Physician
21574
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100103090B
—
OK
05
—
200505990H
—
OK
05
—
209007509
—
MO
Enumeration date
01/03/2006
Last updated
04/05/2017
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