Individual
DR. GREGORY WILLIAM FAIRLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13420 N PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73120-9007
(405) 478-0633
(405) 478-5218
Mailing address
3555 NW 58TH ST, SUITE 900, OKLAHOMA CITY, OK 73112-4707
(405) 917-0418
(405) 917-0419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3850
OK
Other
Enumeration date
10/11/2005
Last updated
07/08/2007
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