Gary Dwayne Raleigh NP

NPI 1336333442 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1336333442
Gender Male
Enumeration Date 08/31/2007
Last Updated 08/03/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
503 S ASPEN
BROKEN ARROW OK, 74012, US
Phone (918) 331-9184
Fax (918) 331-9187
Business Location
6906 E 83RD ST N
OWASSO OK, 74055-7290, US
Phone (918) 341-6873
Fax
Toxanomy
Taxonomy Code 363L00000X
License State Oklahoma
License Number 60070
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According to our database, Gary Dwayne Raleigh NP NPI is 1336333442, taxonomy code is 363L00000X and license number is 60070, license state is located at Oklahoma. Gary Dwayne Raleigh NP physically located at 503 S Aspen, Broken Arrow OK, 74012. NPI Number Gary Dwayne Raleigh NP has the Individual type.

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1336333442 NPI number is provided on an as is basis without warranty of any kind. 1336333442 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Dwayne Raleigh NP are for informational purposes only.