Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 15592 | OK |
NPI | 1003813171 |
---|---|
Provider Name | Reginald Gene Scott |
First Address | Tulsa, OK 74136-3402 |
Second Address | Tulsa, OK 74136-3402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 17/06/2010 |