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General NPI Number Information
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NPI Number | 1114920071
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Entity Type | Individual
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Provider Name | BOB R ABERNATHY DO
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 1200 N GLENN ENGLISH
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City | CORDELL
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State | OK
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Zip | 73632-2010
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Country | US
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Telephone | 580-832-3838
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Fax | 580-832-5119
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Provider Business Mailing Address
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Address Line | 1220 N GLENN L ENGLISH ST
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City | CORDELL
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State | OK
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Zip | 73632-2010
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Country | US
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Telephone | 580-832-3339
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Fax | 580-832-5076
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2075
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License Number State | OK
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