Individual
JAMES WILLIAM STALLCUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 457-6928
Mailing address
PO BOX 1635, TAHLEQUAH, OK 74465-1635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27612
OK
Other
Enumeration date
08/09/2006
Last updated
03/12/2020
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