| NPI | 1982881173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON JAMES BEAN Provider 405-794-6691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: OK 185) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 185) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2016-01-08 |