Organization
NICOLE L. CUPP DPM PLLC
Active
Other names
Advanced Podiatry of Bartlesville
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE LYNN CUPP DPM (PHYSICIAN)
(918) 331-6422
Entity
Organization
Contact information
Practice address
226 SE DEBELL AVE, BARTLESVILLE, OK 74006-2343
(918) 876-0476
(918) 876-0479
Mailing address
226 SE DEBELL AVE, BARTLESVILLE, OK 74006-2343
(918) 876-0476
(918) 876-0479
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
301
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200526540A
—
OK
Enumeration date
06/14/2015
Last updated
06/14/2015
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