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Individual

GERALD SEEFELDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
66 CEDAR RIDGE RD, BROKEN ARROW, OK 74011-1101
(918) 286-6960
Mailing address
66 CEDAR RIDGE RD, BROKEN ARROW, OK 74011-1101
(918) 286-6960

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15842
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100213640A
OK
01
800522535
MEDICARE GROUP PIN
OK
Enumeration date
03/28/2006
Last updated
06/25/2013
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