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NPI Code Detail

MEDICARE: ROBERT GLEN GAMMON JR. LICENSED HEARING AID

MEDICARE: ROBERT GLEN GAMMON JR. LICENSED HEARING AID
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
1237700000XHearing Instrument Specialist1006OK

General Provider Information

NPI Number : 1639357015
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT GLEN GAMMON JR. LICENSED HEARING AID
Provider Business Mailing Address
First Line : 8020 N MAY AVE
Second Line : SUITE A
City : OKLAHOMA CITY
State : OK
Zip : 73120-4543
Country : US
Telephone Number : 405-946-6464
Fax Number : 405-463-6654
Provider Business Practice Location Address
First Line : 8020 N MAY AVE
Second Line : SUITE A
City : OKLAHOMA CITY
State : OK
Zip : 73120-4543
Country : US
Telephone Number : 405-946-6464
Fax Number : 405-463-6654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2008
Last Update Date : 07/23/2014

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Directions to “ ROBERT GLEN GAMMON JR. LICENSED HEARING AID” Practice Location

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