Individual
DR. GARY LEE DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 NE 1ST ST, PRYOR, OK 74361-8850
(918) 824-7767
(918) 824-6410
Mailing address
1301 NE 1ST ST, PRYOR, OK 74361-8850
(918) 824-7767
(918) 824-6410
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14290
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194650A
—
OK
05
—
200039950A
—
OK
Enumeration date
04/14/2006
Last updated
10/13/2011
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