Active NPI
Louis Edgar Mulkey, DO
- Family Medicine Physician
- Tulsa, OK
National Provider Identifier
1043287147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3479
- Practice address
- 1111 S St Louis Ave
Tulsa, OK 74120 - Phone
- (918) 619-4600
- Fax
- (918) 619-4601
- NPI assigned
- Mar 7, 2006
- Last updated
- Nov 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3479 | OK | Primary |
Addresses
Primary practice location
1111 S St Louis Ave
Tulsa, OK 74120
Mailing address
1334 N Lansing Ave
Tulsa, OK 74106-5907
Phone (918) 587-2171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3479 | OK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541376000000",
"number": "1043287147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1334 N LANSING AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741065907",
"telephone_number": "918-587-2171",
"fax_number": "918-295-6106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 S ST LOUIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "74120",
"telephone_number": "918-619-4600",
"fax_number": "918-619-4601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULKEY",
"first_name": "LOUIS",
"middle_name": "EDGAR",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2018-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "3479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.