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Individual

DR. RAJI M GILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1500 EAST DOWNING, SUITE 100, TAHLEQUAH, OK 74464
(918) 458-5700
(918) 458-5790
Mailing address
1500 EAST DOWNING SUITE 100, TAHLEQUAH, OK 74464
(918) 458-5700
(918) 458-5790

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
3753
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100125770A
OK
01
604532300
DEPT OF LABOR
Enumeration date
10/24/2006
Last updated
09/30/2009
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