Individual
GARY DEAN JAMES I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 931-7667
Mailing address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 931-7667
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73-1242962
DRUG AND ALCOHOL TREATMENT CENTER
OK
Enumeration date
04/18/2014
Last updated
04/18/2014
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