Gerald Lewis Dickman, D.O., PLLC
Clinic/Center, Primary Care in Oklahoma City, OK. Organization (NPI-2).
NPI number1497944573
StatusActive
Last updated in NPPESOct 17, 2007
Details
- NPI
- 1497944573
- Entity type
- Organization (NPI-2)
- Legal business name
- Gerald Lewis Dickman, D.O., PLLC
- Organization subpart
- No
- Enumeration date
- Oct 15, 2007
- Last updated
- Oct 17, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 1726 | OK | Yes |
Practice location
3400 Nw ExpresswayBuilding C, Suite 604
Oklahoma City, OK 73112-4493
Phone 405-945-4828 · Fax 405-945-4831
Mailing address
3400 Nw ExpresswayBuilding C, Suite 604
Oklahoma City, OK 73112-4493
Phone 405-945-4828 · Fax 405-945-4831
Authorized official
Gerald Lewis Dickman
Physician
4059454828
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