Individual
GARY P MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
716 S HWY 77, NEWKIRK, OK 74647-5525
(580) 362-2555
(580) 362-2948
Mailing address
212 N MAIN ST, FAIRFAX, OK 74637-3023
(918) 642-3100
(918) 642-5639
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
10503
OK
207Q00000X
Family Medicine Physician
Primary
10503
OK
207R00000X
Internal Medicine Physician
10503
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100183860B
—
OK
Enumeration date
02/20/2006
Last updated
02/20/2013
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