Individual
JAMES MICHAEL REBIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
421 E. HARTFORD AVE., PONCA CITY, OK 74601
(580) 718-4502
(580) 765-2123
Mailing address
421 E. HARTFORD AVE, PONCA CITY, OK 74601
(580) 718-4502
(580) 765-2123
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
3595
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175940A
—
OK
01
—
300522256
OK MEDICARE
OK
Enumeration date
06/22/2005
Last updated
07/26/2013
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