Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 4076 | OK |
NPI | 1134140924 |
---|---|
Provider Name | Debbie Gladd Foley |
First Address | Tulsa, OK 74136-2117 |
Second Address | Tulsa, OK 74136-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 17/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I34534 | (02) | OK |