Organization
ULTIMATE SPORTS & ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ALAN GILLES M.D. (OWNER)
(580) 338-4400
Entity
Organization
Contact information
Practice address
1754 N. ROOSEVELT ST., SUITE # 300, GUYMON, OK 73942-2730
(580) 338-4400
(580) 338-4402
Mailing address
1754 N ROOSEVELT ST, SUITE # 300, GUYMON, OK 73942-2730
(580) 338-4400
(580) 338-4402
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
25543
OK
Other
Enumeration date
05/29/2007
Last updated
09/02/2008
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