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General NPI Number Information
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NPI Number | 1083827646
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Entity Type | Organization
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Legal Business Name | MCBRIDE CLINIC, INC.
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 400 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3208
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Country | US
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Telephone | 405-230-9200
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Fax | 405-330-5591
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Provider Business Mailing Address
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Address Line | 400 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3208
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Country | US
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Telephone | 405-230-9200
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Fax | 405-330-5591
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Authorized Official
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Title or Position | CEO
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Name | MARK GALLIART
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Credential |
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Telephone | 405-486-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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