1609915834 NPI number — MR. BOBBY F GEE DPH

Table of content: MR. BOBBY F GEE DPH (NPI 1609915834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609915834 NPI number — MR. BOBBY F GEE DPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEE
Provider First Name:
BOBBY
Provider Middle Name:
F
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609915834
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3230 NORTHRIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PURCELL
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73080-2123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-527-7405
Provider Business Mailing Address Fax Number:
405-527-5399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 N GREEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PURCELL
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73080-1811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-527-2107
Provider Business Practice Location Address Fax Number:
405-527-5399
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  8191 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100234160C , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100234160A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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