Individual
DR. GARY MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
718 AVENUE A, BEAVER, OK 73932-3101
(580) 625-3477
(580) 625-3562
Mailing address
PO BOX 640, BEAVER, OK 73932-0640
(580) 625-3477
(580) 625-3562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24441
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124441
CHAMPUS
—
05
—
200058570A
—
OK
Enumeration date
01/24/2006
Last updated
09/08/2014
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