Individual
DR. DANIEL A PUMMILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1261 E TULSA AVE, KANSAS, OK 74347-7026
(918) 868-2175
(918) 868-2944
Mailing address
PO BOX 80, KANSAS, OK 74347-0080
(918) 868-2175
(918) 868-2944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12734
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53055
BCBS AR
AR
Enumeration date
05/10/2006
Last updated
07/10/2007
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