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Individual

DR. JAMES NELSON CORNWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
514 PLAZA CT, SAND SPRINGS, OK 74063
(918) 215-5100
(918) 215-5105
Mailing address
514 PLAZA CT, SAND SPRINGS, OK 74063-7915
(918) 215-5100
(918) 215-5105

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6310
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200769410A
OK
01
675798
MEDICARE
OK
Enumeration date
05/21/2014
Last updated
02/12/2019
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