Tulsa Behavioral Medicine LLC

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

10770 Issued in OK

Legal business name

TULSA BEHAVIORAL MEDICINE LLC

Practice address

5272 S Lewis Ave
Suite 220
Tulsa, OK 74105-6544

Phone

(918) 938-7701

Fax

(918) 938-7006

NPI assigned

Mar 25, 2013

Organization subpart

No

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

Authorized official

Name

Walter Jay Exon, M.D.

Title

President

Phone

(918) 938-7701

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1659613016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5272 S LEWIS AVE",
            "address_2": "SUITE 220",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056544",
            "telephone_number": "918-938-7701",
            "fax_number": "918-938-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5272 S LEWIS AVE",
            "address_2": "SUITE 220",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056544",
            "telephone_number": "918-938-7701",
            "fax_number": "918-938-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA BEHAVIORAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-25",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "EXON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-938-7701",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health",
            "state": "OK",
            "license": "10770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Psychologist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Health Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.