Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 2858 | OK |
N | 207X00000X | Orthopaedic Surgeon | 2858 | OK |
NPI | 1558393637 |
---|---|
Provider Name | Gary Raymond Denny |
First Address | Tulsa, OK 74135-5018 |
Second Address | Tulsa, OK 74135-5018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 12/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100136930D | (05) | OK |
798213 | MEDICARE (01) | OK |
E99743 | (02) |