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NPI Code Detail

MEDICARE: DR. GARY W BREIPOHL MD

MEDICARE:  DR. GARY W BREIPOHL  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician16657OK
2207L00000XAnesthesiology Physician54361AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2050072987OTHEROKRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14854514OTHEROKCIGNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083609861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY W BREIPOHL MD
Provider Business Mailing Address
First Line : DEPT 1654
Second Line :
City : TULSA
State : OK
Zip : 74182-0001
Country : US
Telephone Number : 405-947-8585
Fax Number : 405-948-6507
Provider Business Practice Location Address
First Line : 9423 E 95TH CT
Second Line :
City : TULSA
State : OK
Zip : 74133-5805
Country : US
Telephone Number : 918-496-2400
Fax Number : 405-948-6507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 11/20/2017

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Directions to “ DR. GARY W BREIPOHL MD” Practice Location

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