Organization
NORTH CENTRAL OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BERRY GILBERT MD (PHYSICIAN)
(580) 762-6676
Entity
Organization
Contact information
Practice address
121 PATTON DR, PONCA CITY, OK 74601-2030
(580) 762-6676
(580) 762-0094
Mailing address
121 PATTON DR, PONCA CITY, OK 74601-2030
(580) 762-6676
(580) 762-0094
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200071520A
—
OK
Enumeration date
03/29/2006
Last updated
04/30/2008
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