Harley Elijah Gossen, DO
Student in an Organized Health Care Education/Training Program in Tulsa, OK. Individual provider (NPI-1).
NPI number1649166307
StatusActive
Last updated in NPPESJun 17, 2025
Details
- NPI
- 1649166307
- Entity type
- Individual (NPI-1)
- Name
- Harley Elijah Gossen
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 17, 2025
- Certification date
- Jun 17, 2025
- Last updated
- Jun 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1111 W 17th StTulsa, OK 74107-1886
Phone 405-437-6140
Mailing address
1013 Justin DrYukon, OK 73099-2178
Phone 405-437-6140
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