Individual
DR. GAVIN VANWEY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9303 N 101ST EAST AVE, OWASSO, OK 74055-6841
(918) 557-2658
Mailing address
9303 N 101ST EAST AVE, OWASSO, OK 74055-6841
(918) 557-2658
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4296
OK
Other
Enumeration date
07/04/2007
Last updated
07/08/2007
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