MEDICARE: DR. KAREN GAIL SMALLWOOD RYAN M.D.

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
1	2083X0100X	Occupational Medicine Physician	118336	MO
2	2083X0100X	Occupational Medicine Physician	18688	OK

General Provider Information

NPI Number	:	1437134657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN GAIL SMALLWOOD RYAN M.D.

Provider Business Mailing Address
First Line	:	7820 E 15TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74112-7832
Country	:	US
Telephone Number	:	918-622-6606
Fax Number	:	573-339-7946

Provider Business Practice Location Address
First Line	:	7820 E 15TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74112-7832
Country	:	US
Telephone Number	:	918-622-6606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	07/11/2007

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