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Individual

GEMINI J BOGIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5622 N PORTLAND AVE STE 200, OKLAHOMA CITY, OK 73112-2000
(405) 528-8193
(405) 528-0626
Mailing address
PO BOX 258881-8881, SECTION# 141, OKLAHOMA CITY, OK 73125
(405) 418-4800
(405) 418-4820

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20219
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100119270B
OK
Enumeration date
11/08/2005
Last updated
06/04/2018
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