Organization
MCBRIDE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GALLIART (CEO)
(405) 486-2100
Entity
Organization
Contact information
Practice address
400 N BRYANT AVE, EDMOND, OK 73034-3208
(405) 230-9200
(405) 330-5591
Mailing address
400 N BRYANT AVE, EDMOND, OK 73034-3208
(405) 230-9200
(405) 330-5591
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100758280B
—
OK
Enumeration date
05/08/2007
Last updated
10/28/2010
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