Individual
MARK GUBICHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(316) 644-5755
Mailing address
2428 S MARION AVE, TULSA, OK 74114-3428
(316) 644-5755
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
110276
OK
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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