MEDICARE: DR. GAYLE L FLYNN EDD

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	101Y00000X	Counselor
2	1744R1102X	Research Study Specialist

General Provider Information

NPI Number	:	1770994170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAYLE L FLYNN EDD

Provider Business Mailing Address
First Line	:	105 N CARRIE LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73117-8412
Country	:	US
Telephone Number	:	405-427-0918
Fax Number	:

Provider Business Practice Location Address
First Line	:	3344 NE 14TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73117-6206
Country	:	US
Telephone Number	:	405-427-0918
Fax Number	:

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

Provider Enumeration Date	:	05/19/2014
Last Update Date	:	05/19/2014

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