Individual
MR. GUS D CANADAY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1312 S GARNETT RD, SUITE E, TULSA, OK 74128-1811
(918) 437-2500
(918) 437-2535
Mailing address
1312 S GARNETT RD, STE E, TULSA, OK 74128-1811
(918) 437-2500
(918) 437-2535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0067546
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100171360B
—
OK
Enumeration date
06/07/2006
Last updated
05/10/2011
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