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Individual

BOB R ABERNATHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1200 N GLENN ENGLISH, CORDELL, OK 73632-2010
(580) 832-3838
(580) 832-5119
Mailing address
1220 N GLENN L ENGLISH ST, CORDELL, OK 73632-2010
(580) 832-3339
(580) 832-5076

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2075
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08013806
RAILROAD MC
05
100101100A
OK
01
100101100C
SOONERCARE CHOICE
OK
01
125307900
DOL
OK
01
321802700
DEPARTMENT OF LABOR
OK
Enumeration date
05/24/2005
Last updated
07/18/2016
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