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Gordon J Bean Dpm INC

Podiatrist in Moore, OK. Organization (NPI-2).

NPI number1982881173
StatusActive
Last updated in NPPESJan 8, 2016

Details

NPI
1982881173
Entity type
Organization (NPI-2)
Legal business name
Gordon J Bean Dpm INC
Organization subpart
No
Enumeration date
Jan 30, 2008
Last updated
Jan 8, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X Podiatrist185OKYes
332B00000X Durable Medical Equipment & Medical Supplies185OK

Practice location

3001 S Telephone Rd
Ste B
Moore, OK 73160-5424

Phone 405-794-6691 · Fax 405-794-9856

Mailing address

3001 S Telephone Rd
Ste B
Moore, OK 73160-5424

Phone 405-794-6691 · Fax 405-794-9856

Authorized official

Gordon James Bean
Provider
4057946691

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