Individual
TERRY R GERARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8803 S 101ST E AVE, SUITE 360, TULSA, OK 74133
(918) 582-0001
(918) 582-0003
Mailing address
PO BOX 26303, OKLAHOMA CITY, OK 73126-0303
(918) 582-0001
(918) 582-0003
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2040
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100162190A
—
OK
01
—
2456392702
TIED TO SS#
KS
05
—
2456392702
—
KS
01
—
462507531-006
BCBS TIED TO 73-1554259
OK
Enumeration date
09/12/2006
Last updated
06/12/2020
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