MEDICARE: DR. TERRY MICHAEL GILE 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	2276	OK
2	207L00000X	Anesthesiology Physician	2276	OK

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	:	1962412999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY MICHAEL GILE D.O.

Provider Business Mailing Address
First Line	:	3840 S 103RD EAST AVE STE 100
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-2445
Country	:	US
Telephone Number	:	918-921-9700
Fax Number	:	918-292-8263

Provider Business Practice Location Address
First Line	:	3840 S 103RD EAST AVE STE 100
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-2445
Country	:	US
Telephone Number	:	918-921-9700
Fax Number	:	918-292-8263

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	11/16/2021

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