Individual
LAURA SHANNON GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
102 N BROADWAY, CARNEGIE, OK 73015-9800
(800) 942-2904
Mailing address
1813 ABILENE CT, GRAND PRAIRIE, TX 75052-2200
(405) 474-7757
(405) 410-9795
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
22979
OK
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
22979
OK
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
E7262
AR
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
MD.206032
LA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
N6124
TX
208D00000X
General Practice Physician
Primary
22979
OK
208D00000X
General Practice Physician
N6124
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200086480B
—
OK
01
—
22979
OK LICENSE #
OK
Enumeration date
07/02/2006
Last updated
11/26/2024
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