Individual
MR. GARY D CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2825 PARKLAWN DR, MIDWEST CITY, OK 73110-4201
(405) 610-4411
Mailing address
5301 SUN VALLEY DR, GUTHRIE, OK 73044-9562
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
11784
OK
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
11784
OK
207Q00000X
Family Medicine Physician
11784
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100110920A
—
OK
Enumeration date
05/02/2006
Last updated
06/21/2010
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