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Individual

MR. GARY DEAN DUBOIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1117 S DOUGLAS BLVD, STE D, MIDWEST CITY, OK 73130-5262
(405) 741-8686
(405) 733-9621
Mailing address
1117 S DOUGLAS BLVD, STE D, MIDWEST CITY, OK 73130-5262
(405) 741-8686
(405) 733-9621

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12879
OK
207RN0300X
Nephrology Physician
Primary
12879
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100117310A
OK
Enumeration date
08/24/2005
Last updated
02/20/2008
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