J Clark Bundren, M.D., PC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

13630 Issued in OK

Legal business name

J CLARK BUNDREN, M.D., PC

Practice address

5555 E 71St St Ste 6220
Tulsa, OK 74136-6548

Phone

(918) 492-6000

Fax

(918) 481-0622

NPI assigned

Nov 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Clark Bundren, M.D.NPI 1649240045

Title

Managing Officer

Phone

(918) 492-6000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Clark Bundren, MD

  • Reproductive Endocrinology Physician
  • Tulsa, OK
  • NPI 1649240045
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1013199157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E 71ST ST STE 6220",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366548",
            "telephone_number": "918-492-6000",
            "fax_number": "918-481-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E 71ST ST STE 6220",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366548",
            "telephone_number": "918-492-6000",
            "fax_number": "918-481-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J CLARK BUNDREN, M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "BUNDREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "MANAGING OFFICER",
        "authorized_official_telephone_number": "918-492-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OK",
            "license": "13630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qiana Nakesha Marie Ivory
• Chaisse Ivy
• Charles Ivy
• Jenna Ivy
• Prashanth S Iyer, MD
• J E Block, M.D., Facp
• J Frederick McNeer MD PLLC
• J Home Care, Inc. Dba Atoz Medical
• J Ross Inc.
• J. Bert Johnson DDS, Inc, P.C.

• Gynecology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Gynecology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.