Basic Information
Provider Information
NPI: 1790826485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRAMONTE
FirstName: VALLORY
MiddleName: JOHN
NamePrefix:  
NameSuffix: II
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1705 E 19TH ST
Address2: STE 302
City: TULSA
State: OK
PostalCode: 741045410
CountryCode: US
TelephoneNumber: 9187487585
FaxNumber: 9184036352
Practice Location
Address1: 1705 E 19TH ST
Address2: STE 302
City: TULSA
State: OK
PostalCode: 74104
CountryCode: US
TelephoneNumber: 9187487585
FaxNumber: 9184036352
Other Information
ProviderEnumerationDate: 02/08/2007
LastUpdateDate: 08/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X24514OKY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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