MEDICARE: GARY RAYMOND DENNY D.O.

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	207RA0401X	Addiction Medicine (Internal Medicine) Physician	2858	OK
2	207X00000X	Orthopaedic Surgery Physician	2858	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	798213	OTHER	OK	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1558393637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY RAYMOND DENNY D.O.

Provider Business Mailing Address
First Line	:	5310 E 31ST ST FL 13
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5018
Country	:	US
Telephone Number	:	918-561-5701
Fax Number	:	918-561-1173

Provider Business Practice Location Address
First Line	:	5310 E 31ST ST FL 11 STE 1102
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5018
Country	:	US
Telephone Number	:	918-561-1700
Fax Number	:	918-561-1701

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	03/29/2022

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Directions to “ GARY RAYMOND DENNY D.O.” Practice Location

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