Gary E Theobald in Broken Arrow - General Practice
Gary E Theobald - NPI 1467597104
Gary E Theobald is a General Practice in Broken Arrow, Oklahoma. Gary E Theobald practices all healthcare services and medical treatments related to General Practice. The NPI Number for Gary E Theobald is 1467597104. The last update date is 2007-07-08.
Gary E Theobald's current location address is 2619 S Elm Pl, Broken Arrow, Oklahoma. You can contact this provider via phone number 9184550811 and fax number 9184514787. The mailing address for Gary E Theobald is 2619 S Elm Pl, Broken Arrow, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary E Theobald |
|---|---|
| Address | 2619 S Elm Pl, Broken Arrow, Oklahoma |
| Phone Number | 9184550811 |
| Fax Number | 9184514787 |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1467597104 |
|---|---|
| Provider Enumeration Date | 2007-02-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2619 S Elm Pl |
|---|---|
| City | Broken Arrow |
| State | Oklahoma (OK) |
| Post Code | 740127878 |
| Phone Number | 9184550811 |
| Fax Number | 9184514787 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 3804 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identification code assigned to Gary E Theobald by the Centers for Medicare & Medicaid Services?
The Gary E Theobald has been issued the NPI (National Provider Identifier) 1467597104, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Gary E Theobald's facilities are situated?
The facilities of Gary E Theobald are physically located at the following address: 2619 S Elm Pl, Broken Arrow, OK, 740127878.
What is Gary E Theobald's area of expertise and its corresponding taxonomy classification?
The Gary E Theobald's field of specialization is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1467597104 assigned to Gary E Theobald?
The Gary E Theobald was issued its 1467597104 on 2007-02-20, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Gary E Theobald, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Gary E Theobald, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
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