Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M3541 | TX |
N | 111NI0900X | Internist | M3541 | TX |
Y | 207RG0100X | Gastroenterologist | 4981 | OK |
NPI | 1013022680 |
---|---|
Provider Name | Dr. Geoffrey Alan Fillmore |
First Address | Tulsa, OK 74133-5834 |
Second Address | Tulsa, OK 74133-5834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 23/02/2017 |