Individual
GARY L PADDACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
902 ARLINGTON CTR, PMB 224, ADA, OK 74820-2883
(580) 436-2262
(580) 272-0186
Mailing address
902 ARLINGTON CTR, PMB 224, ADA, OK 74820-2883
(580) 436-2262
(580) 272-0186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12905
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100143120B
—
OK
Enumeration date
03/09/2006
Last updated
01/11/2008
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