Individual
DR. MARK HENRY GROSSERODE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6565 S YALE AVE, STE 812, TUSLA, OK 74136-8354
(918) 494-9486
(918) 494-9480
Mailing address
6565 S YALE AVE, STE 812, TUSLA, OK 74136-8354
(918) 494-9486
(918) 494-9480
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
18167
OK
Other
Enumeration date
12/28/2005
Last updated
07/08/2007
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