Individual
DR. JAMES EDWARD BOURDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6465 S YALE AVE, SUITE 507, TULSA, OK 74136-7823
(918) 481-2760
(918) 481-2775
Mailing address
6465 S YALE AVE, SUITE 507, TULSA, OK 74136-7823
(918) 481-2760
(918) 481-2775
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
17511
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17511
STATE MEDICAL LICENSE
OK
Enumeration date
08/30/2006
Last updated
02/14/2013
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