Provider Demographics
NPI:1144734047
Name:DENNE, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DENNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 W FREEPORT ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-2406
Mailing Address - Country:US
Mailing Address - Phone:918-632-0033
Mailing Address - Fax:918-632-0034
Practice Address - Street 1:721 W FREEPORT ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-2406
Practice Address - Country:US
Practice Address - Phone:918-632-0033
Practice Address - Fax:918-632-0034
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies