Individual
GARY BOB FRALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 W I 35 FRONTAGE RD, EDMOND, OK 73034-7328
(405) 509-2800
(405) 509-2885
Mailing address
4401 W MEMORIAL RD, SUITE 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13265
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104960B
—
OK
Enumeration date
06/03/2006
Last updated
05/20/2014
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