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1578598074
WALTER MARK BOOMER
TULSA, OK
NPI
1578598074
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RP1001X Internal Medicine, Pulmonary Disease
(Licence: OK 17300)
Enumeration Date
2006-07-12
Last Update Date
2021-10-28
Business Address
WALTER MARK BOOMER MD
2832 E 101ST ST
TULSA, OK 74137-5601
Phone number: 918-771-4455
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Mailing Address
WALTER MARK BOOMER MD
PO BOX 3478 DEPT A
TULSA, OK 74101-3478
Phone number: 918-494-9288
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